[Acanthamoeba keratitis: search for a healthy carrier in Mali]

The first cases of Acanthamoeba keratitis in Africa were reported in 1990 at the Institute of African Tropical Ophthalmology (IOTA) in Bamako, Mali. From 1990 to 1995, a total of 22 cases of corneal ulcers involving Acanthamoeba sp. were diagnosed at the IOTA. To improve our understanding of the epidemiological characteristics of these lesions in tropical areas, we attempted to identify healthy carriers of Acanthamoeba sp. by studying the normal eye flora of 149 patients examined at the IOTA in February 1996. Acanthamoeba sp. was not detected in any sample. Fungi were detected in 22.15 p. 100 of the samples. Thus, it would appear that, unlike fungi, Acanthamoeba sp. is not present in normal eye flora in Mali. This findings suggests that the occurrence of Acanthamoeba in corneal ulcers is not an accident. Our results also emphasize the need for screening to detect Acanthamoeba in developing countries such as Mali. However, further study will be needed to confirm these findings in a larger group of subjects more closely matched with the patients presenting the corneal ulcers diagnosed at the IOTA, especially with regard to geographical origin.