The Predicted Implications of Paederin Exposure to the Eye: A Paederus Outbreak During the Sudan War in 2025

Abstract

Background: The Sudanese armed conflict has severely harmed the health system, causing infectious disease outbreaks. Paederus ocular dermatitis, induced by the toxins (paederin) of Paederus beetles, exhibits a clinical presentation that closely resembles several other conditions. This study aims to assess the potential effects of paederin on the ocular region during the Paederus outbreak in the Sudan War of 2025. Methods: This is a hospital-based cross-sectional study. All patients with paederin contact with the eye who presented to the Ophthalmology Clinic of the first author in El-Obeid City, North Kordofan State, Sudan, between 5 July and 5 August 2025 were enrolled for the study. The patients selected had no previous eye disease (specifically infectious conjunctivitis, corneal ulcers, and chronic dermatitis). Out of 250 patients who presented to the clinic with paederin eye contact, only 100 were included in the study. Each of these patients was assessed for ocular clinical symptoms at the initial presentation using the available instruments and devices in the clinic. Results: Out of the 100 included patients, periorbital dermatitis was found in 80% of cases, followed by itching in 85%, pain in 80%, hyperpigmented skin around the eye in 70%, lid ulcer in 38%, redness in 36%, and lid swelling in 28%. Only 2% of women experienced conjunctivitis, while 8% developed vesicles. The reported number might be much lower than the true number of casualties due to the exclusion criteria. Conclusion: The massive outbreak of Paederus may be associated with the ramifications of the current armed war in Sudan. The ocular clinical manifestation is analogous to that seen in other outbreaks in different areas.