Background People with diabetes have an increased risk of developing sight-threatening conditions. Sight threatening diabetic retinopathy (STDR) is an advanced microvascular of complication of diabetes on the eye. It remains one of the leading causes of preventable blindness among working age adults around the world. There is a paucity of evidence on the prevalence of STDR and its associated factors in Ethiopia, particularly in the study area. Therefore, the aim of our study was to determine the prevalence of STDR and its associated factors among adult diabetes patients at Debre Tabor General Hospital (DTGH), Northwest Ethiopia. Materials and Methods An institution-based cross-sectional study was conducted on 306 diabetes patients at Debre Tabor General Hospital with systematic random sampling technique. Semi-structured questionnaire, document review and physical examination were applied to collect the data. Binary and multivariable logistic regression model were used to identify associated factors for STDR. Results The majority of the participants 163 (53.3%) were type 1 diabetes (T1DM) and the mean age of T1 and T2 DM participants was 34.5 (12.8) and 58.7 (10.7) years respectively. The prevalence of STDR was 15.3% (95%CI: 9.6%-20.9%) and 11.9% (6.6-17.5) in T1DM and T2DM, respectively. Low family monthly income (adjusted odds ratio (AOR)=4.4, 95%CI: 1.05-18.40) among T2DM, longer duration of diabetes (AOR=10.9, 95%CI: 2.94-40.4) among T1DM (AOR=3.54, 95CI: 1.06-11.8) among T2DM and poor glycemic control (AOR=3.93, 95%CI: 1.06-14.5) and hypertension (AOR=5.86, 95%CI: 1.20-28.6) among T1DM and BMI (AOR=4.79, 95%CI: 1.35-17.00) among T2DM were significantly associated with STDR. Conclusion and Recommendation The prevalence of STDR was high. Low family monthly income, longer duration of diabetes, poor glycemic control, hypertension and obesity were positively associated with STDR. Early screening of STDR and improving diabetes self management in all diabetes patients were recommended.

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Sight-threatening Diabetic Retinopathy and Associated Risk Factors Among Adult Diabetes Patients at Debre Tabor General Hospital, Northwest Ethiopia.

Objective Contemporary data on the attainment of optimal diabetes treatment goals and the burden of diabetes complications in adult populations with type 2 diabetes in Africa are lacking. We aimed to document the current status of attainment of three key indicators of optimal diabetes care and the prevalence of five diabetes complications in adult African populations with type 2 diabetes. Methods We systematically searched Embase, PubMed and the Cochrane library for published studies from January 2000 to December 2020. Included studies reported any information on the proportion of attainment of optimal glycated haemoglobin (HbA1c), blood pressure (BP) and low-density lipoprotein cholesterol (LDLC) goals and/or prevalence of five diabetes complications (diabetic peripheral neuropathy, retinopathy, nephropathy, foot ulcers and peripheral arterial disease). Random effect model meta-analysis was performed to determine the pooled proportion of attainment of the three treatment goals and the prevalence of five diabetes complications. Results In total, 109 studies with a total of 63 890 participants (53.3% being females) were included in the meta-analysis. Most of the studies were conducted in Eastern African countries (n=44, 40.4%). The pooled proportion of attainment of an optimal HbA1c, BP and LDLC goal was 27% (95% CI 24 to 30, I2=94.7%), 38% (95% CI 30 to 46, I2=98.7%) and 42% (95% CI 32 to 52, I2=97.4%), respectively. The pooled prevalence of diabetic peripheral neuropathy, retinopathy, diabetic nephropathy, peripheral arterial disease and foot ulcers was 38% (95% CI 31 to 45, I2=98.2%), 32% (95% CI 28 to 36, I2=98%), 31% (95% CI 22 to 41, I2=99.3%), 19% (95% CI 12 to 25, I2=98.1%) and 11% (95% CI 9 to 14, I2=97.4%), respectively. Conclusion Attainment of optimal diabetes treatment goals, especially HbA1c, in adult patients with type 2 diabetes in Africa remains a challenge. Diabetes complications, especially diabetic peripheral neuropathy and retinopathy, are highly prevalent in adult populations with type 2 diabetes in Africa.

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Indicators of optimal diabetes care and burden of diabetes complications in Africa: a systematic review and meta-analysis

PURPOSE: Diabetic retinopathy (DR) is one of the most serious complications of diabetes mellitus (DM). It is the most common cause of blindness among the working age group in the developed world and the fifth leading cause of global blindness. In Sub-Saharan Africa, 2.8% of all blindness is caused by DR. Studies addressing the prevalence of DR and associated factors are scarce in Ethiopia. The objective of this study was to determine the Prevalence and associated factors of DR development among DM patients attending University of Gondar, Tertiary Eye Care and Training center. METHODS: A cross-sectional study was carried out from March 2019 to February 2020 involving all consecutive diabetes patients who visited the center during the study period. Data were collected using a semi-structured questionnaire and data extraction check list and entered into SPSS version 20 and analyzed. Univariate and multivariable logistic regression analysis were done to identify predictors of DR. Statistical significance was determined with 95% confidence interval (CI) using odds ratio and P RESULTS: A total of 225 DM patients with a mean age of 55.4 ± 13.5 years were studied, of whom 95 (42.2%) had DR. Duration of diabetes ≥6 years (AOR = 2.91: 95% CI; 1.01–8.35) and baseline age CONCLUSION: The prevalence of DR among our study patients was very high. Longer duration of diabetes, higher systolic blood pressure, baseline age

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Prevalence of Diabetic Retinopathy and Risk Factors among Diabetic Patients at University of Gondar Tertiary Eye Care and Training Center, North-West Ethiopia.

Background Diabetic retinopathy is the most common microvascular complication of diabetes mellitus on eye and it is the leading cause of visual impairment among productive segment of the population. Globally, the prevalence of diabetic retinopathy is reported to be 27%. In Ethiopia, sufficient data is lacking on the prevalence of diabetic retinopathy as well as information on its predisposing factors. The study was required to assess the prevalence of diabetic retinopathy and its predisposing factors in diabetic patients attending at a General Hospital in Ethiopia. Methods An institution based cross sectional study was employed on 331 diabetic patients recruited with a systematic random sampling technique. Data were collected through structured questionnaire, tracing patients’ medical folder and ocular health examination. Data were analyzed with Statistical Package for Social Science Version 20. Logistic regression methods of analysis were used to figure out predisposing factors of diabetic retinopathy. Adjusted odds ratio with 95% confidence interval was used to determine the strength of association. Result A total of 331 diabetic patients completed the study with a response rate of 99.10%. The median duration of diabetes was 5 years. The prevalence of diabetic retinopathy was 34.1% (95%Confidence Interval (CI): 28.7%-39.3%). Low family monthly income (Adjusted Odds Ratio (AOR) = 7.43, 95% CI: 2.44–22.57), longer duration of diabetes (AOR = 1.44, 95% CI: 1.30–1.58), poor glycemic control (AOR = 4.76, 95%CI: 2.26–10.00), and being on insulin treatment alone (AOR = 3.85, 95%CI: 1.16–12.74) were independently associated with diabetic retinopathy. Conclusion and recommendation The prevalence of diabetic retinopathy was 34.1%, higher than national and global figures. Low family monthly income, longer duration of diabetes, poor glucose control and being on insulin treatment alone were important risk factors of diabetic retinopathy. Proper diabetes self management and early screening of diabetic retinopathy in all diabetic patients were recommended.

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Prevalence of diabetic retinopathy among diabetic patients in Northwest Ethiopia—A cross sectional hospital based study

Aim: To assess the prevalence of diabetic retinopathy and its associated risk factors among adult diabetes at Debre Tabor General Hospital, Debre Tabor, Northwest, Ethiopia.
Methodology: A cross sectional study was conducted at Debre Tabor General Hospital from June 29-August 28, 2020. A systematic random sampling technique was employed to select study participants. Interviewer based semistructured questioner, document review and physical examination were applied to collect the data. Labeling of diabetic retinopathy was done based on the Proposed International Clinical Diabetic Retinopathy and Severity Scale. Only the eye with the higher grade of retinopathy for each participant was included.
Result: A total of 306 participants completed the study with a response rate of 97.7%. The median duration of diabetes was 4 (Range=7) years. The prevalence of diabetic retinopathy was 31.4% (95% Confidence Interval: 26.1%-36.3%). Low family monthly income (Adjusted Odds Ratio=7.4, 95% Confidence Interval 2.4-22.9), longer duration of diabetes (Adjusted Odds Ratio=27, 95% Confidence Interval 11.5-63.6) and poor glycemic control (Adjusted Odds Ratio=3.2, 95%Confidence Interval 1.5-6.7) were significantly associated with diabetic retinopathy.
 Conclusion and Recommendation: The prevalence of diabetic retinopathy washigh. Coordinated early screening of diabetic retinopathy in all adult diabetes was recommended.

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Tejal Magan

Papers

Prevalence and severity of diabetic retinopathy in patients attending the endocrinology diabetes clinic at Mulago Hospital in Uganda