Ocular Manifestations among HIV Infected Children in Ouagadougou, Burkina Faso

Caroline Yonaba,Aissata Kabore,Kigocha Okengo,Kongnimissom Apoline Sondo,Chantal Zoungrana,Ludovic Kam,Flore Ouédraogo,Madi Nacoulma,Angèle Kalmogho,Fla Koueta

doi:10.4236/ojped.2016.62027

Abstract

Ocular manifestations among HIV infected children are diverse and global incidence varies from 7% to 75%. At this age, eye lesions are often unnoticed because of the incapacity to express eye discomfort. The purpose of this study is to describe ocular manifestations among HIV-infected children and hence associated factors in the Department of Paediatrics at the Yalgado Ouédraogo Teaching Hospital. This was a cross-sectional descriptive and analytical study conducted between July 2014 and December 2014. A complete ophthalmic examination was systematically done to all HIV-positive children attending the clinic, as part of their routine medical visit. The most recent socio-demographic, clinical, biological and treatment data were registered. Seventy-nine children had an ocular examination and among them 92.4% were on ARV treatment. The incidence of ocular manifestations was 46.7%. Median age was 8 years old (interquartile 6 - 12 years old). Sex ratio was 1.3. The risk of ocular manifestations involvement among boys was twice than that of girls. More than half (59.5%) of children who had ocular problems had not expressed ocular discomfort. Ocular adnexal lesions were more common (35.4%) compared to eye segments (8.9%) lesions. Anterior segment and posterior segment lesions were statistically associated with immune system depression (p = 0.003 and 0.001). However, this relationship was not statistically significant (p = 0.15). Five out of seven children who had eye fundus lesions had CD4 count 3. Ocular manifestations were very common among HIV infected children in our context. Ophthalmic examination should be systematic at admission and regularly repeated during follow-up.

Highlights

At the end of 2012, it was estimated that 2 million children under 15 years old were infected by HIV in Sub-Saharan Africa, which was almost 62% of the world total population in this age group [1]
Ocular manifestations may be observed at all stages of immuno-depression and may affect any eye segment
Children whose parents signed the consent form were convened for a complete ophthalmic examination at the ophthalmology department

Summary

Introduction

At the end of 2012, it was estimated that 2 million children under 15 years old were infected by HIV in Sub-Saharan Africa, which was almost 62% of the world total population in this age group [1]. In 2014, the number of children under 15 years living with HIV in Burkina Faso was estimated to be 13.000 [11.000 - 15.000] [2]. In our context, diagnosis is often late, adhesion to ARV treatment insufficient and complications frequent. Among these complications ocular lesions occupy an important place [3]. The incidence of ocular complications in HIV-infected patients varies from 42% to 75% and some of these complications may lead to blindness [3]-[5]. The incidence and the gravity of lesions depend on immune status [3] [4] [6]

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Discussion

Conclusion