A survey of eye disease in a high risk HIV group - Commercial Sex Workers in Majengo Nairobi, Kenya
Abstract
Introduction: HIV infection is an important cause of morbidity and mortality worldwide.
It has several associated eye afflictions, many leading to blindness. The study was done
to determine the prevalence and magnitude of eye disease in a group at high risk for HIV:
the Majengo commercial sex worker (CSW) cohort. Previous studies done have not
examined high risk groups. This study was done to determine the prevalence of such
effects and see if high risk people differ from the normal population.
Method: A cross sectional survey was done in the CSW clinic at Majengo, Nairobi. This
is an open cohort of CSWs on follow-up by the department of Microbiology, University
ofNairobi. The study period was between November 2003 and December 2003.
Results: There are over 600 CSWs on regular follow-up at the Majengo clinic. 151
subjects aged between 21 years and 56 years were examined.l07 were Kenyan, 40
Tanzanian, 3 Ugandan and 1 Rwandese. 72 were HIV +ve and 79 were HIV -ve. Only
13.9 % of the HIV+ve CSWs examined were on HAART. The prevalence of general eye
disease in the HIV+ve andmv negative subsets was 86.1% and 69.6% respectively. .
The prevalence of HIV related eye illnesses in the HIV+ve CSWs was 18.1% with
choroidal lesions being the most common. Profound .immw10deficiency characterized by
a CD4 count less than 50 was observed in 4 CSWs. While 3 of these CSWs were
assymptomatic, one had a retinal hemorrhage and tortuous blood vessels suggestive of
HIV retinopathy.
Discussion: Studies done in non-high risk groups found prevalence of HIV related eye
illness ranging between 30-80%. The lower prevalence in the C.S.W cohort can be
attributed to the fact that some members of this cohort have special immunity to HIV as
characterized by HIV specific cytotoxic Tvlymphocytes and genital mucosal antibodies.
Thus, a close follow-up is needed to document ocular findings in these CSWs at regular
intervals.
Citation
M.Med (Ophthalmology) ThesisSponsorhip
University of NairobiPublisher
Department of Medicine, University of Nairobi
Description
Master of Medicine Thesis