Uptake of Screening for Diabetic Retinopathy and Associated Factors among Adults with Diabetes Mellitus Aged 18-65 Years: A Descriptive Cross Sectional Study
Article Main Content
The prevalence of diabetes in Zimbabwe has increased significantly in the past three decades posing serious challenges to the provision of care and prevention of disabling co-morbidities in an already disadvantaged healthcare setting. Studies conducted in Zimbabwe have reported prevalence of 16% to 38%. Diabetic retinopathy, a major complication of diabetes, is a leading cause of blindness globally and of an estimated 285 million people with diabetes worldwide approximately 33.3% have signs of diabetic retinopathy and of these a further 33.3% have vision threatening diabetic retinopathy. The purpose of this study is to examine uptake of screening for diabetic retinopathy and associated factors among adults aged 18-65 years with diabetes at Parirenyatwa Group of Hospitals. This was a cross sectional analytical study on a random sample of 83 adults aged 18-65 years with diabetes mellitus. The study was conducted according to the requirements of the Declaration of Helsinki. A structured questionnaire was used to collect data in strict privacy and confidentiality. Uptake of screening was 53%. The chi-square test was done to analyse demographic factors associated with uptake of screening. Male gender and being married were significantly associated with higher uptake of screening (p=0.029 and p=0.037 respectively). Logistic regression was done to determine predictors of uptake of screening services for diabetic retinopathy. On logistic regression, gender (OR=0.241, 95% CI [0.079 – 0.735]) and misinformation (OR=0.280, 95% CI [0.081 – 0.974]) were significant predictors of uptake of screening. Uptake of diabetic retinopathy screening was sub-optimal. Gender and misinformation were significant barriers to uptake of screening. There is need to address barriers to uptake of retinopathy screening to promote timely identification and management of complications in people with diabetes mellitus.
References
-
Mutowo, M., et al., Prevalence of diabetes in Zimbabwe: a systematic review with meta-analysis. International journal of public health, 2015. 60(1): p. 1-11.
DOI |
Google Scholar
1
-
Maboreke, N.P., Prevalence of diabetic retinopathy at Parirenyatwa hospital. 2016.
Google Scholar
2
-
Machingura, P.I., et al., Prevalence and risk factors associated with retinopathy in diabetic patients at Parirenyatwa Hospital outpatients’ clinic in Harare, Zimbabwe. Archives of Medical and Biomedical Research, 2017. 3(2): p. 104-111.
DOI |
Google Scholar
3
-
Matimba, A., et al., Tele-ophthalmology: opportunities for improving diabetes eye care in resource-and specialist-limited sub-Saharan African countries. Journal of telemedicine and telecare, 2016. 22(5): p. 311-316.
DOI |
Google Scholar
4
-
Lee, R., T.Y. Wong, and C. Sabanayagam, Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss. Eye and vision, 2015. 2(1): p. 17.
DOI |
Google Scholar
5
-
Reichel, E. and D. Salz, Diabetic retinopathy screening, in Managing Diabetic Eye Disease in Clinical Practice. 2015, Springer. p. 25-38.
DOI |
Google Scholar
6
-
Lake, A., Reducing risk of vision loss for young adults with type 2 diabetes, 2018, Deakin University.
Google Scholar
7
-
Graham-Rowe, E., et al., Barriers and enablers to diabetic retinopathy screening attendance: Protocol for a systematic review. Systematic reviews, 2016. 5(1): p. 134.
DOI |
Google Scholar
8
-
Moreton, R., et al., Factors determining uptake of diabetic retinopathy screening in Oxfordshire. Diabetic Medicine, 2017. 34(7): p. 993-999.
DOI |
Google Scholar
9
-
Kashim, R., P. Newton, and O. Ojo, Diabetic retinopathy screening: A systematic review on patients’ non-attendance. International journal of environmental research and public health, 2018. 15(1): p. 157.
DOI |
Google Scholar
10
-
Hipwell, A., et al., Attitudes, access and anguish: a qualitative interview study of staff and patients’ experiences of diabetic retinopathy screening. BMJ open, 2014. 4(12): p. e005498.
DOI |
Google Scholar
11
-
Scanlon, P.H., The english national screening programme for diabetic retinopathy 2003–2016. Acta diabetologica, 2017. 54(6): p. 515-525.
DOI |
Google Scholar
12
-
Bressler, S.B., et al., Change in diabetic retinopathy through 2 years: secondary analysis of a randomized clinical trial comparing aflibercept, bevacizumab, and ranibizumab. JAMA ophthalmology, 2017. 135(6): p. 558-568.
DOI |
Google Scholar
13
-
Ahmed, R.A., S.N. Khalil, and M.A. Al-Qahtani, Diabetic retinopathy and the associated risk factors in diabetes type 2 patients in Abha, Saudi Arabia. Journal of family & community medicine, 2016. 23(1): p. 18.
DOI |
Google Scholar
14
-
Nentwich, M.M. and M.W. Ulbig, Diabetic retinopathy-ocular complications of diabetes mellitus. World journal of diabetes, 2015. 6(3): p. 489.
DOI |
Google Scholar
15
-
Lima, V.C., et al., Risk factors for diabetic retinopathy: a case–control study. International journal of retina and vitreous, 2016. 2(1): p. 21.
DOI |
Google Scholar
16
-
Bhavsar, A. and R. Khardori, Diabetic retinopathy, 2019.
Google Scholar
17
-
Mendanha, D.B.d.A., et al., Risk factors and incidence of diabetic retinopathy. Revista Brasileira de Oftalmologia, 2016. 75(6): p. 443-446.
DOI |
Google Scholar
18
-
Ting, D.S.W., G.C.M. Cheung, and T.Y. Wong, Diabetic retinopathy: global prevalence, major risk factors, screening practices and public health challenges: a review. Clinical & experimental ophthalmology, 2016. 44(4): p. 260-277.
DOI |
Google Scholar
19
-
Blows, P., T. Peto, and K. Mbulawa, Empowering patients with diabetic retinopathy. Community eye health, 2015. 28(92): p. s14.
Google Scholar
20
-
Jacomelli, J. Diabetic eye screening annual data 1 April 2015 to 31 March 2016. 2017.
Google Scholar
21
-
Mwangi, N., et al., Predictors of uptake of eye examination in people living with diabetes mellitus in three counties of Kenya. Tropical medicine and health, 2017. 45(1): p. 41.
DOI |
Google Scholar
22
-
Poore, S., et al., Planning and developing services for diabetic retinopathy in Sub-Saharan Africa. International journal of health policy and management, 2015. 4(1): p. 19.
DOI |
Google Scholar
23
-
Lindenmeyer, A., et al., Influence of primary care practices on patients’ uptake of diabetic retinopathy screening: a qualitative case study. Br J Gen Pract, 2014. 64(625): p. e484-e492.
DOI |
Google Scholar
24
-
Flaxman, S.R., et al., Global causes of blindness and distance vision impairment 1990–2020: a systematic review and meta-analysis. The Lancet Global Health, 2017. 5(12): p. e1221-e1234.
Google Scholar
25
-
Al-Alawi, A., et al., Knowledge, attitude, and perception of barriers for eye care among diabetic persons registered at Employee Health Department of a Tertiary Eye Hospital of Central Saudi Arabia. Middle East African journal of ophthalmology, 2016. 23(1): p. 71.
DOI |
Google Scholar
26
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