[1] Univ Hosp Cleveland, Div Geog Med, Cleveland, OH 44106 USA
[2] Univ Hosp Cleveland, Dept Ophthalmol, Cleveland, OH 44106 USA
[3] Case Western Reserve Univ, Cleveland, OH 44106 USA
[4] Bernhard Nocht Inst Trop Med, D-20359 Hamburg, Germany
[5] Univ Liverpool, Liverpool Sch Trop Med, Liverpool L3 5QA, Merseyside, England