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

Author(s):  
Tesfahun Ejigu ◽  
Asmere Tsegaw

Abstract 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 patterns of DR and associated factors are scarce in Ethiopia. The objective of this study was to determine the Prevalence and associated factors of DR among DM patients attending University of Gondar (UOG), Tertiary Eye Care and Training center.Patients and 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 multivariate logistic regression analysis were done to identify predictors of DR. Statistical significance was determined with 95% confidence interval using odds ratio and p-values.Results: A total of 225 DM patients with 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 < 60 years (AOR= 3.2: 95%CI; 1.19 - 8.63) were significantly associated with DR. Diabetic retinopathy was significantly associated with the form of therapy. Those on insulin (p=0.025), and oral hypoglycemic agents (OHA) with insulin combination (p=0.014) had statistically significantly associated with development of DR. Patients with systolic blood pressure of <140 mmHg were 3.6 times (AOR=0.28:95%CI:0.09-0.82) less likely to have DR. A majority of patients had Non-proliferative DR (NPDR) without diabetic macular edema (DME) (34.2%). DME and proliferative DR (PDR) were seen in 5.7% and 3.6% of the patients respectively. Vision threatening DR (VTDR) was seen in 10.7% of patients. There was significant association between age <60 years and VTDR (AOR=4.19: 95%CI; 1.23-14.35).Conclusion: The prevalence of DR among our study patients was very high. Longer duration of diabetes, higher systolic blood pressure, baseline age < 60 years, use of insulin alone and use of combination of insulin with OHA were independently associated with DR. Health education; early screening and treatment are recommended.

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Melkamu Temeselew Tegegn ◽  
Gizachew Tilahun Belete ◽  
Ayanaw Tsega Ferede ◽  
Aragaw Kegne Assaye

Introduction. Low vision is a worldwide health problem in both developing and developed countries. A national survey of low vision and blindness in Ethiopia showed that the prevalence of low vision was 3.7% and that of blindness was 1.6%, whereas there is no evidence in the study area. Purpose. The study was aimed to assess the proportion and associated factors of low vision at the University of Gondar tertiary eye care and training center. Methods. A hospital-based cross-sectional study was conducted on 727 study participants with a systematic random sampling technique from April 18 to May 16, 2019. Data were collected through the use of a structural questionnaire and physical eye examination. Data were entered into Epi Info version 7, and analysis was performed by using statistical package for social science (SPSS) version 20. The binary logistic regression model was fitted to identify factors associated with low vision, and variables with a P value of <0.05 in a multivariable binary logistic regression were considered as statistically significant. Results. A total of 715 study participants have participated in this study with a mean age of 49.39 ± 19.93 years. The prevalence of low vision was 35.7% (95% CI: 32.3, 39.3). Being female (AOR = 1.58; 95% CI: 1.10, 2.28), no formal educational level (AOR = 2.24; 95% CI: 1.25, 4.02), history of cataract surgery (AOR = 2.58; 95% CI: 1.53, 4.36), and age ≥ 70 years (AOR: 3.96; 95% CI: 2.21, 7.10) were significantly associated with low vision. Conclusion and Recommendation. The prevalence of low vision found in this study was high as compared with the national and global magnitude. Older age, being female, previous history of cataract surgery, and no formal education were independently and significantly associated with low vision. Cataract and uncorrected refractive errors were identified as the main causes of low vision. Therefore, it requires a plan to provide an eye care education to the community, increasing the quality of cataract surgery and refractive service for the community in the catchment area.


PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0252064
Author(s):  
Mikias Mered Tilahun ◽  
Betelhem Temesgen Yibekal ◽  
Habtamu Kerebih ◽  
Fisseha Ademassu Ayele

Purpose This study aimed to assess the prevalence of common mental disorders and associated factors among adults with glaucoma at Gondar university comprehensive specialized hospital tertiary eye care and training center. Glaucoma predisposes patients to common mental problems and leads to wasteful, costly and inefficient use of medical services and complications of the diagnoses. So, determining the level and factors associated with common mental disorders among glaucoma patient would help to improve and integrate comprehensive ophthalmic services which address common mental disorder in a follow-up visit. Methods An institution-based cross-sectional study was conducted on 495 glaucoma patients selected by using systematic random sampling. Data were collected through face-to-face interview and chart review. Self-reported questionnaire (SRQ-20) was used to assess the presence of common mental disorders. Binary logistic regression analysis was done to identify factors associated with common mental disorders. Variables with P<0.05 were considered as factors significantly associated with common mental disorders. Result Four hundred sixty-eight patients were included in this study with a response rate of 94.54%. The mean age of the participant was 58 ± 14.11 years. The prevalence of common mental disorders was found to be 29.5% (95% CI 25.4–33.3). Female sex (AOR = 3.79, 95% CI: 1.66–8.62) (p-value = 0.001), average monthly income of less than 1200 birr (AOR = 6.05 95% CI: 2.26–16.22) (p-value = 0.001), poor level of social support (AOR = 17.39 95% CI: 7.79–38.82) (p-value = 0.001), moderate and high risk of alcohol use (AOR = 10.42 95%CI: 2.74–39.54) (p-value = 0.001), presence of chronic medical illness (AOR = 3.85 95% CI: 2.07–7.16) (p-value = 0.001), receiving both drug and surgical treatment (AOR = 2.50, 95%CI: 1.30–4.83) (p-value = 0.006) and presence of systemic carbonic anhydrase inhibitors use (AOR = 3.16, 95%CI: 1.65–6.06) (p-value = 0.001) were significantly associated with increased level of common mental disorders. Conclusion Significant numbers of glaucoma patients have CMD and found significantly associated with socio-economic, ocular and systemic clinical factors. Therefore, the integration of psychosocial care into the current treatment of patients with glaucoma would have a significant advantage to help these patients.


2020 ◽  
Vol 2020 ◽  
pp. 1-15
Author(s):  
Wondimeneh Shibabaw Shiferaw ◽  
Tadesse Yirga Akalu ◽  
Yared Asmare Aynalem

Background. Though different primary studies have reported the burden of chronic kidney disease among diabetes patients, their results have demonstrated substantial variation regarding its prevalence in Ethiopia. Therefore, this study aimed to estimate the pooled prevalence of chronic kidney disease and its associated factors among diabetes patients in Ethiopia. Method. PubMed, African Journals Online, Google Scholar, Scopus, and Wiley Online Library were searched to identify relevant studies. The I2 statistic was used to check heterogeneity across the included studies. A random-effects model was applied to estimate the pooled effect size across studies. A funnel plot and Egger’s regression test were used to determine the presence of publication bias. All statistical analyses were performed using STATA™ version 14 software. Result. In this meta-analysis, a total of 12 studies with 4,075 study participants were included. The estimated prevalence of CKD among diabetes patients was found to be 35.52% (95% CI: 25.9–45.45, I2 = 96.3%) for CKD stages 1 to 5 and 14.5% (95% CI: 10.5–18.49, I2 = 91.1%) for CKD stages 3 to 5. Age greater than 60 years (OR = 2.99; 95% CI: 1.56–5.73), female sex (OR = 1.68; 95% CI: 1.04–2.69), duration of diabetes >10 years (OR = 2.76; 95% CI: 1.38–5.51), body mass index >30 kg/m2 (OR = 2.06; 95% CI: 1.41–3.00), type 2 diabetes (OR = 2.54; 95% CI: 1.73–3.73), poor glycemic control (OR = 2.01; 95% CI: 1.34–3.02), fasting blood glucose >150 mg/dl (OR = 2.58; 95% CI: 1.79–3.72), high density lipoprotein >40 mg/dl (OR = 0.48; 95% CI: 0.30–0.85–25), systolic blood pressure>140 mmHg (OR = 3.26; 95% CI: 2.24–4.74), and diabetic retinopathy (OR = 4.54; CI: 1.08–25) were significantly associated with CKD. Conclusion. This study revealed that the prevalence of chronic kidney disease remains high among diabetes patients in Ethiopia. This study found that a long duration of diabetes, age>60 years, diabetic retinopathy, female sex, family history of kidney disease, poor glycemic control, systolic blood pressure, overweight, and high level of high-density lipoprotein were associated with chronic kidney disease among diabetic patients. Therefore, situation-based interventions and context-specific preventive strategies should be developed to reduce the prevalence and risk factors of chronic kidney disease among diabetes patients.


Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Isaac Owusu ◽  
Fred Adomako-Boateng ◽  
Fred Kueffer ◽  
Molly Guy ◽  
Chemuttaai Lang’at ◽  
...  

Background: Logistic and socioeconomic barriers limit effective blood pressure (BP) control in many parts of Sub-Saharan Africa, including the Republic of Ghana. We tested a novel hypertension management model of care designed for resource-limited settings. Methods and Results: The “Akoma Pa” model was developed using human-centered design methodology involving patients, physicians, and nurses. The model consisted of a mobile tablet, BP machine and a novel software application in a unique platform to allow for longitudinal patient management. Patients were provided with a tailored hypertension management plan based on their enrollment comorbidities and risk factors. A cohort of 150 hypertensive patients (57±8 years; 73% female) accessed regular blood pressure assessments at a local pharmacy and received real-time automated feedback based on their individualized plan. On the mobile application, clinicians were able to view patient data, provide patients with feedback via SMS on their condition, and write electronic prescriptions which could be accessed by participating pharmacies. Average baseline BP was 135±18/84±10 mmHg in the overall cohort and 153±13/90±11 mmHg in the subgroup with uncontrolled hypertension (n=58). After 6 months of voluntary weekly monitoring, systolic blood pressure decreased significantly (p<0.01) in the overall cohort (-4.7±18.7 mmHg) and in the uncontrolled subgroup (-15.2±17.6mmHg). Systolic blood pressure remained constant in the sub group with controlled pressure at baseline. The proportion of the population with uncontrolled hypertension decreased from 39% to 27% (p=0.01). Patient compliance with weekly BP assessments was 61% and 2,855 BP assessments were conducted. During 33 of the 2,855 BP assessments (1% of pharmacy visits), the software application directly referred patients to a health facility (33 visits in 25 patients). Improvement in overall health awareness was reported in 82% of the participants and 95% of participants indicated a desire to continue using this model in the future. Conclusions: Compliance and satisfaction with this multifaceted hypertension care model were high and led to significant and sustained decreases in blood pressure in this West African hypertensive population.


2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Yordanos Tsehai Jemberu ◽  
Yared Assefa Woldie ◽  
Wossen Mulugeta ◽  
Destaye Shiferaw Alemu ◽  
Getasew Mulat Bantie

Background. For so long, corneal diseases have been known as one of the leading causes to blindness in the global. This blindness might be due to failure to accept the corneal transplantation. Therefore, this study aimed to determine the prevalence and the root challenges for corneal transplantation acceptance at the University of Gondar tertiary eye care and training center, Ethiopia. Methods. An institution-based cross-sectional study was conducted among patients who had an indication for corneal transplantation at the University of Gondar tertiary eye care and training center since January 1, 2017, up to October 30, 2018. A structured questionnaire was used to collect the data and entered into Epi-Info 7 software and analyzed using SPSS version 20. Simple logistic regression was used to identify the associated factors of corneal transplantation acceptance. Associations between outcome and exposure variables were expressed by the adjusted odds ratio with a 95% confidence interval and p value <0.05. Result. A total of 116 patients with a mean age of 51 (±21) years participated in the study. The overall acceptance level of corneal transplantation was only 38.8% (95% CI: 29.93, 47.66). Patients with poor knowledge [AOR = 2.41; 95% CI: 1.90, 6.48] and an unfavorable attitude [AOR = 6.33; 95% CI: 2.42, 16.54] were significantly associated with the acceptance of corneal transplantation. Conclusion. The study revealed that the corneal transplantation acceptance level was very low. Hence, the government and other concerned stakeholders should give due emphasis to the awareness creation and behavior change communication strategies to increase the acceptance level of corneal transplantation.


2016 ◽  
Vol 235 (3) ◽  
pp. 141-149 ◽  
Author(s):  
Elizabeth M. Webb ◽  
Paul Rheeder ◽  
Polla Roux

Objective: The aim of the study was to determine the prevalence of diabetic retinopathy, maculopathy and visual loss in primary care patients and to identify associated risk factors. Research Design and Methods: We conducted a cluster randomised trial at primary care clinics in the Tshwane district in South Africa. Grades of retinopathy and maculopathy (with fundus camera) and visual acuity (Snellen chart) were assessed and, using mobile screening and teleophthalmology, clinical and biochemical testing was conducted to obtain information about glycaemic control and microvascular complications. Results: The prevalence rates for any retinopathy, preproliferative retinopathy and proliferative retinopathy were 24.9, 19.5 and 5.5%, respectively. The prevalence rates of diabetic maculopathy, observable maculopathy and referable maculopathy were 20.8, 11.8 and 9.0%, respectively. The presence of retinopathy was associated with high body mass index, systolic blood pressure, being on insulin treatment, high HbA1c and the presence of neuropathy. High systolic blood pressure, being on insulin treatment, high HbA1c level and high low-density lipoprotein cholesterol level as well as the presence of albuminuria were significant in predicting any diabetic maculopathy. Laser photocoagulation was given to 8.3% of patients from the mobile unit and 12% of patients were referred to the nearest hospital with an outpatient eye clinic for follow-up treatment of various other eye conditions. Using the WHO categories, the study found that 78.1% of diabetes patients had normal vision, 19.3% were visually impaired and 2.2% were severely impaired or blind. Conclusion: High prevalence rates for diabetic retinopathy, maculopathy and visual loss were found and associations were identified.


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