Diabetic Retinopathy in Tanzania: prevalence and risk factors at entry into a regional screening programme.

Cleland, CR; Burton, MJ; Hall, C; Hall, A; Courtright, P; Makupa, WU; Philippin, H; (2015) Diabetic Retinopathy in Tanzania: prevalence and risk factors at entry into a regional screening programme. Tropical medicine & international health. ISSN 1360-2276 DOI: https://doi.org/10.1111/tmi.12652

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The number of adults with diabetes in sub-Saharan Africa (SSA) is expected to almost double by 2035. This study investigated the prevalence of diabetic retinopathy (DR) and its risk factors at entry into a community-based screening programme. All persons with diabetes screened for retinopathy at entry into a screening programme in Kilimanjaro Region, Tanzania between November 2010 and December 2014 were included. Fundus photographs were taken with a Topcon retinal camera following pupil dilation. Data were collected on BP, random blood sugar, duration of diabetes, BMI and visual acuity on entry. A total of 3187 were screened for DR. The prevalence of any DR was 27.9% (95%CI 26.4-29.5%) with background diabetic retinopathy (BDR), pre-proliferative diabetic retinopathy (PPDR) and proliferative diabetic retinopathy (PDR) having a prevalence of 19.1% (95%CI 17.7-20.4%), 6.0% (95%CI 5.2-6.8%) and 2.9% (95%CI 2.3-3.5%), respectively. Maculopathy was present in 16·1% (95%CI 14·8-17·4%) of participants. Multivariable logistic regression analysis for the presence of any DR found independent associations with duration of diabetes (p<0.0001), systolic BP (p<0.0001), random blood sugar (p<0.0001) and attending a government hospital diabetic clinic (p=0.0339). This study is the first to present data from a DR screening programme in SSA. The results will provide policy makers with data to aid planning of DR screening and treatment services in the African region. The study highlights the importance of managing co-morbidities within DR screening programmes. This article is protected by copyright. All rights reserved.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Research Centre: International Centre for Eye Health
PubMed ID: 26644361
Web of Science ID: 371509400012
URI: http://researchonline.lshtm.ac.uk/id/eprint/2388362


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