RESUMO
To determine the influence of onchocercal eye disease on the intraocular pressure of the Yanomami Tribe Aratha-ú of Roraima State, Brazil, considered endemic for onchocerciasis, a total of 86 patients were submitted to an ophthalmologic exam that included external examination, slit lamp examination, intraocular pressure measurement, and a fundus ophthalmoscope examination. A high prevalence of onchocerciasis-related eye lesions was encountered in 68.6% of the patients. Punctate keratitis and microfilariae in the anterior chamber were found in â¼28%. The mean of intraocular eye pressure found was 10.47 mm of Hg.
Assuntos
Oncocercose Ocular/epidemiologia , Oncocercose Ocular/patologia , Adolescente , Adulto , Idoso , Anti-Helmínticos/uso terapêutico , Brasil/epidemiologia , Criança , Feminino , Humanos , Pressão Intraocular , Ivermectina/uso terapêutico , Masculino , Pessoa de Meia-Idade , Oncocercose Ocular/tratamento farmacológico , Grupos Populacionais , Adulto JovemRESUMO
The prevalence of ocular lesions due to onchocerciasis was evaluated among residents of the Yanomami Tribe, in the northern Amazon, Brazil, an endemic area for onchocerciasis. 83 natives were submitted to an ocular examination including an external examination, biomicroscopy, intraocular pressure measurement, and a fundus examination. Clinical, parasitological and serological tests were carried out simultaneously. The population demonstrated a high prevalence of eosinophilia, skin microfilaria (55%) and onchocercal subcutaneous nodules (35%). A high prevalence of probable onchocerciasis related eye lesions was detected. Punctate keratitis (41%) and microfilaria in the anterior chamber (39%) were found as well as other probable onchocercotic lesions-chorioretinitis (7.2%) and anterior uveitis (6.0%). Other anterior eye lesions (corneal leucomas, conjunctival injection, lid nodules) occurred in 51% of the individuals. The anterior eye lesions were more prevalent than the posterior lesions. We did not find an association of glaucoma with onchocerciasis. The prevalence of these suggestive ocular lesions strongly correlates with the cutaneous nodules and eosinophilia, suggesting that skin nodules may be an indication for an eye examination. The present study provides evidence that significant infection and eye disease due to onchocerciasis persists in certain regions of Northern South America.
Assuntos
Oncocercose Ocular/epidemiologia , Oncocercose Ocular/patologia , Adolescente , Adulto , Animais , Câmara Anterior/parasitologia , Brasil/epidemiologia , Criança , Pré-Escolar , Coriorretinite/parasitologia , Eosinofilia , Feminino , Humanos , Lactente , Recém-Nascido , Ceratite/parasitologia , Masculino , Pessoa de Meia-Idade , Onchocerca/isolamento & purificação , Oncocercose Ocular/complicações , Grupos Populacionais , Prevalência , Pele/patologia , Uveíte Anterior/parasitologia , Adulto JovemRESUMO
World Health Organization certification criteria for onchocerciasis elimination use anterior segment eye lesion prevalence as an indicator of mass ivermectin treatment program success. Lesions either contain visible microfilaria (noninflammatory punctate keratitis [PK] or microfilariae in anterior chamber [MFAC]), or microfilaria obscured by inflammation (inflammatory PK). To assess the utility of these disease indicators, two experienced ophthalmologists independently examined persons from endemic (N = 325) and nonendemic (N = 348) Guatemalan communities. Thirty-six (11.1%) and nine (2.6%) persons from endemic and nonendemic areas respectively had lesions found by either ophthalmologist (prevalence ratio = 4.3, 95% CI 2.1-8.8, P < 0.001). All lesions in nonendemic areas were inflammatory PK in whom no persons were seropositive for onchocerciasis. Overall, observer agreement was moderate (Kappa = 0.49), and most (61%) discordance occurred with inflammatory PK lesions. Our findings suggest that inflammatory punctate keratitis is neither a specific nor a reliable indicator of onchocercal eye disease. Future prevalence surveys should rely upon noninflammatory lesions as disease indicators.