Ocular manifestation of Rift Valley Fever as observed in the 2006 epidemic in Kenya
Abstract
Introduction: Rift Valley fever (RVF)is a febrile viral zoonotic disease that affects
ruminants primarily and humans as secondary host. It occurs in low rainfall
plains after abnormally wet season and flooding which promotes mosquito
breeding. Retinitis, macula oedema and transient non-granulommatous anterior
uveitis are common ocular manifestation of the disease" 9, 10, 12, 18. This study
aimed at finding the clinical picture during the 2006/2007 epidemic in Kenya.
Objective: To establish the prevalence and pattern of ocular findings in people
with Rift Valley Fever during the Kenyan epidemic .
Methodology: All the forty seven (47)cases who tested positive to RVFvirus by
peR or IgM antibodies in Baringo and Machakos districts were interviewed and
ocular examination with a slit lamp done. A torch was used to assess pupillary
reflexes. Binocular slit lamp fundoscopy with 90 dioptre loupe and or binocular
indirect fundoscopy was then done with dilated pupil. The data was entered into
and analyzed using the SPSSsoftware package version 12.0.
Results: Of the forty seven cases seen 55.3% were males; majority of the males
were herders (38.5%)and most females were domestic workers (57.1%). Initial
symptoms were fever (91.5%), generalized weakness (91.5%), and headache
(89.5%). Blurred vision was reported in 76.6% of the cases. The subjects gave
history of mosquito bites (95.7%)and contact with animal tissues during cooking
(53.2%), care of sick animals (80.9%), drinking unboiled milk (43.2%) and
delivering aborting animals (36.2%). Ocular signs attributable to RVF were
mainly retinal and occurred in 43.1% of the subjects. Macula oedema (33.7%),
retinitis (22.1%) and retinal vasculitis were the most significant macular and
paramacular findings in the eyes. Vision was affected significantly by their
presence.
Conclusion: There were retinal lesions in 43.1% of our cases that could be
explained by RVFinfection. The retinal lesions look similar to those seen in acute
posterior multifocal placoid pigmentary epitheliopathy (APMPPE).The findings
of this survey may justify the involvement of health workers in the initial
response to the epidemic.
Recommendations: Eye workers need to be involved in early response to RVF
epidemic, and long-term follow-up of cases that had ocular features of RVF to
determine long-term sequelae and potential foveal involvement
Citation
Masters in medicine (Ophthalmology),Sponsorhip
University of NairobiPublisher
Faculty of medicine, Department of Ophthalmology, University of Nairobi