Diabetic Retinopathy and the Risk Factors in South Sudan: A Six Months Study

Abstract

</i>Background</i>: Diabetes Mellitus (DM) remains as one of the global epidemic of Non Communicable Diseases. Diabetic Retinopathy (DR), as one of its complications, has a prevalence of 35.4% worldwide. <i>Objective</i>: The aim of this study was to determine the prevalence and risk factors for DR among DM patients attending Diabetic Clinic in Malakia Health Center, Juba, South Sudan. </i>Design and Method</i>: This was a prospective, cross-sectional study in which diabetic patients attending Diabetic clinic, Malakia Health Center, were recruited for a period of Six months. All Diabetic patients were included and their demographic data recorded. Clinical data of duration of diabetes and hypertension were noted. Their Visual acuity, Blood pressure, Height, Weight, and Random blood sugar were measured. Eyes were examined and anterior segment diseases diagnosed. Funduscopy was done to determine posterior segment diseases and DR classified. Data were entered into SPSS version 22, analyzed and results expressed in statistical tables. Any result of p<0.05 was considered statistically significant. </i>Results</i>: Out of 108 patients and 216 eyes examined, males were 55.6% (60) and females 44.4% (48) with ages ranging from 23 to 75yrs, mean age of 51.1yrs (SD+/10.67). Patients with age 46-65 years had the highest 64.8% (70) and 18-35 years as the lowest 6.5% (8) with p>0.05. Most of these patients 39.8% (43) were from Kator block residential area with p>0.05. Type I DM were 27.8% (30) and Type II 72.2% (78) with p>0.05. DR prevalence was 13% (28) with NPDR the highest 11.6% (25) and PDR the lowest 0.5% (1) with p<0.05. No DR was 64% (139). DME was 7.4% (16) and cataract 3.7% (8). Risk factors for DR among the patients showed that the highest duration of DM was in >5yrs 68.5% (74) with p>0.05, uncontrolled blood glucose was 81.5% (88) with p>0.05, known hypertensive was 48.1% (52), high blood pressure (>120/80 mmHg) was 43.5% (41) with p>0.05 and BMI (>30kg/m² was 23.1% (25) with p<0.05. There were 12% (25), 20% (44), and 68% (147) eyes blind, visual impairment and normal respectively due DR and the other eye conditions (p<0.05). Chi-square test showed BMI, BP and visual acuity were the only strongly associated to DR with P values of 0.007, 0.001 and 0.000 respectively. </i>Conclusion</i>: The study had shown, for the first time in South Sudan, the prevalence of DR as 13% with some of its risk factors. This will influence policy makers to develop strategies to improve management of DM and DR in the country.