Factors associated with participation in a diabetic retinopathy screening program in a rural district in Bangladesh

Abstract

AimDiabetic retinopathy (DR) screening is one of the keys in successful diabetes care, but the participation in DR screening is sub-optimal. This study aims to assess the factors associated with participation in a DR screening program in a rural district of Bangladesh. Method213 persons with diabetes identified in a population-based assessment of over 3000 persons ≥ 40 years were offered free of cost screening for DR. Awareness, attitudes and practice about diabetes and common eye diseases along with socio-demographic factors were assessed. Results68 (32%) patients participated in the screening program. After multivariate adjustment, awareness related to diabetes causes eye disease (odds ratio (OR) 8.47, 95% confidence interval (CI) 3.95–18.18), awareness of DR (OR 5.15, 95% CI 1.89–14.01) and awareness of the possibility to prevent DR-related vision loss (OR 3.15, 95% CI 1.53–6.51) were associated with higher proportion of participation. Lack of confidence upon skills of ophthalmic assistants and fear of complications were barriers but socio-economic condition was not a barrier in attending the screening program. ConclusionsThe major factor associated with participation in DR screening is diabetes-related health literacy in rural Bangladesh. Public health promotion program should be designed to provide health education to increase participation in the screening program.