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Einfluss der HIV-Pandemie auf die Inzidenz maligner Augentumoren im südlichen Malawi (Blantyre)

The influence of the HIV pandemic on the incidence of malignant ocular tumours in Southern Malawi (Blantyre)

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Zusammenfassung

Hintergrund

Die HIV-Pandemie im Südosten Afrikas stellt eine große Herausforderung für die personal- und finanzschwachen Gesundheitssysteme der betroffenen Länder dar. So ist bei ophthalmologischen Patienten in Malawi ein deutlicher Anstieg HIV-assoziierter Tumorerkrankungen festzustellen. In der vorliegenden Studie wurde die Häufigkeit bösartiger Augentumoren (insbesondere Bindehautkarzinome) anhand des Patientenguts der einzigen Augenklinik im Süden Malawis untersucht.

Methoden

Anhand der Operationspläne und Krankenakten der Augenabteilung der medizinischen Fakultät der University of Malawi wurde die jährliche Anzahl der wegen Bindehautneoplasien operierter Patienten für den Zeitraum von 1989–2006 erfasst. Prospektiv wurde 49 konsekutiven Patienten mit malignen Augentumoren ein HIV-Test angeboten.

Ergebnisse

Die Anzahl der malignomverdächtigen Veränderungen der Bindehaut nahm von 32 Fällen im Jahre 1989 auf 467 im Jahr 2006 zu. 80% (39/49) der Patienten mit malignen Augentumoren wiesen ein Bindehautkarzinom oder eine konjunktivale intraepitheliale Neoplasie (CIN) auf. 76% der Patienten mit Bindehautkarzinomen waren HIV-positiv.

Zusammenfassung

Im Süden Malawis ist das Bindehautkarzinom im untersuchten Patientengut inzwischen der mit Abstand häufigste maligne okuläre Tumor. Die Inzidenz scheint im Verlauf von 18 Jahren – parallel zum Anstieg der HIV-Infektionsrate – dramatisch angestiegen zu sein.

Abstract

Background

The HIV pandemic in Southeast Africa is a challenge to the poorly staffed and poorly financed health systems of the affected countries. A dramatic increase of HIV-associated ocular malignancies has been observed in Malawi. This study investigated the frequency of malignant ocular tumours at the only eye hospital in the south of Malawi.

Methods

A retrospective analysis of all patients who underwent removal of conjunctival growth suspicious for malignancy was performed for the period from 1989 to 2006. In addition a consecutive group of 49 patients with malignant ocular tumours was offered an HIV test.

Results

The number of patients undergoing surgery for suspected ocular surface squamous neoplasia (OSSN) increased from 32 cases in 1989 to 467 in 2006. Of the patients with malignant ocular tumours, 80% (39 of 49) had OSSN, and 76% of the patients with OSSN were HIV positive.

Conclusions

OSSN has become the most frequent malignant ocular tumour in the south of Malawi. The incidence of OSSN seems to have increased dramatically from 1989 to 2006 – in parallel to increasing HIV infection rates.

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Authors and Affiliations

  1. Zentrum für Augenheilkunde, Universitäts-Augenklinik Tübingen, Schleichstraße 12, Tübingen, Deutschland

    M.S. Spitzer, P. Szurman, E. Yoeruek & K.U. Bartz-Schmidt

  2. Lions Sight First Eye Hospital, College of Medicine, Blantyre, Malawi

    M.S. Spitzer, T. Chirambo, P. Kayange, P. Szurman & H.N. Batumba

Authors
  1. M.S. Spitzer
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  2. T. Chirambo
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  3. P. Kayange
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  4. P. Szurman
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  5. E. Yoeruek
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  6. K.U. Bartz-Schmidt
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  7. H.N. Batumba
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Correspondence to M.S. Spitzer.

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Spitzer, M., Chirambo, T., Kayange, P. et al. Einfluss der HIV-Pandemie auf die Inzidenz maligner Augentumoren im südlichen Malawi (Blantyre). Ophthalmologe 106, 813–818 (2009). https://doi.org/10.1007/s00347-008-1842-8

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  • DOI: https://doi.org/10.1007/s00347-008-1842-8

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