Prevalence and clinical characteristics of vernal keratoconjunctivitis in sub-Saharan Africa

Abstract

Purpose of review Vernal keratoconjunctivitis (VKC) is a chronic bilateral allergic inflammatory disease of the conjunctiva and cornea that affects children and young adults, especially in sub-Saharan Africa. A limbal form (tropical endemic limbo conjunctivitis) is thought to be more common in the tropics where research on this vision-impairing condition is scanty. We sought to review current literature from sub-Saharan Africa, with a focus on the prevalence of VKC and its clinical presentation. Recent findings There is a variable prevalence of VKC in SSA, up to 32.9% of children, especially in male individuals less than 5 years old, and has been diagnosed in a 4-month-old baby. Associated factors include exposure to dust, personal and family history of atopy, Vitamin D3 deficiency and HIV. The mixed form of VKC is the most frequent form seen and conjunctival pigmentation might be an early diagnostic sign. Summary Childhood screening programs for VKC should be established to reduce the morbidity, decreased quality of life and school absenteeism that is seen in these patients. VKC-related research should be encouraged in this milieu to bring to light the particularities of VKC in SSA.

Prevalence and risk factors of Vernal Keratoconjunctivitis among a Ghanaian clinical cohort: A case‐control study

“… 33 , 34 , 35 This case‐control study is the first which focused exclusively on assessing the prevalence and risk factors associated with VKC in a large clinical cohort in Ghana. The prevalence of VKC among the study sample is within the middle bracket reported for most SSA countries that is, 2.30%−37% 32 but within the upper limit of reported cases in Europe (ranges from 1.2 to 10.6 cases per 10,000 population). 36 The high prevalence in SSA has been linked to the hot climatic conditions in such countries as Ghana, poor socioeconomic status, air pollution, and other comorbidities.…”

“… 37 The variation in the prevalence has been attributed to the diverse geographic and climatic spread. 32 This gives credence to the necessity for jurisdictional‐specific prevalence studies of VKC and further supported the region‐to‐region variation within the same country. The prevalence of 9.45%, though at the point of care could be far less than what exists in the population because barely half of the children (the most affected age group) receive care, and for those who do only 17% visit the clinic two times in a year.…”

“…The scarcity of research from Sub‐Saharan Africa (SSA) on VKC has been noted, and for this reason, VKC‐related studies have been advocated, given the particularities of the disease in the sub‐region. 32 This is more so as most existing studies on ocular allergy are not exclusive to VKC. 33 , 34 , 35 This case‐control study is the first which focused exclusively on assessing the prevalence and risk factors associated with VKC in a large clinical cohort in Ghana.…”