A Prospective Study in Mogadishu, Somalia: Adenovirus, Herpesvirus, and Measles-related Ocular Infections and Complications

Abstract

The aim of this study is to examine the incidence, clinical and epidemiological characteristics of ocular viral infections in consecutive patients admitted to the ophthalmology outpatient clinic of a tertiary education and research hospital located in Mogadishu-Somali. In the study, it was aimed to reach data that could be specific for the country and city where the study was conducted by examining patients in different age and gender groups with findings compatible with viral infections in their clinical examinations in terms of risk factors and complications. The study was conducted as a four-month (December 2019-March 2020) prospective follow-up study and included the analysis of data from 63 patients. Eight (12.7%) of the patients were affected bilaterally by infection and related complications, and 55 patients were affected in one eye (25 left eyes and 30 right). In this study based on clinical examination results, the frequency of viral eye infections was found as adenovirus 66.7% (42/63), herpes simplex virus 27.0% (17/63), herpes zoster virus 4.76% (3/63), and measles virus 1.59% (1/63), respectively. HIV serology was negative for all patients. The most common complications were as follows; keratitis 87.3% (55/63), conjunctivitis 84.1% (53/63), anterior uveitis 15.9% (10/63) and glaucoma 17.5% (11/63). Anterior uveitis, cataract, synechia and glaucoma occurrence rates were found to be significantly higher in patients with hypertension and/or diabetes mellitus (p<0.05). While 28 of the patients (44.4%) could not provide any information on the place of transmission where the infection was acquired, the most frequently reported possible transmission sites were 23 homes (36.5%) and 10 workplaces (15.9%). It was determined that adenovirus infections affect a wide age group (9-60 years; mean: 28.0±10.7), herpes simplex virus infections affected young and middle-aged individuals (16-52 years; mean: 31.3±11.36 years) and herpes zoster virus infections affected older age groups (45-69 years; mean: 56.3±12). Our study data show that reducing the burden of viral eye infections and related complications in Mogadishu, Somali population living in crowded families and in conditions with lack of infrastructure depends on many parameters such as access to health services, early treatment, control of chronic diseases and public health awareness, and viral eye infections and it shows that the burden of related complications can be possible with the development of socio-economic and general public health conditions together.