Abstract

The prevalence of diabetes in Zimbabwe has increased significantly in the past three decades posing serious challenges to the provision of care and prevention of disabling co-morbidities in an already disadvantaged healthcare setting. Studies conducted in Zimbabwe have reported prevalence of 16% to 38%. Diabetic retinopathy, a major complication of diabetes, is a leading cause of blindness globally and of an estimated 285 million people with diabetes worldwide approximately 33.3% have signs of diabetic retinopathy and of these a further 33.3% have vision threatening diabetic retinopathy. The purpose of this study is to examine uptake of screening for diabetic retinopathy and associated factors among adults aged 18-65 years with diabetes at Parirenyatwa Group of Hospitals. This was a cross sectional analytical study on a random sample of 83 adults aged 18-65 years with diabetes mellitus. The study was conducted according to the requirements of the Declaration of Helsinki. A structured questionnaire was used to collect data in strict privacy and confidentiality. Uptake of screening was 53%. The chi-square test was done to analyse demographic factors associated with uptake of screening. Male gender and being married were significantly associated with higher uptake of screening (p=0.029 and p=0.037 respectively). Logistic regression was done to determine predictors of uptake of screening services for diabetic retinopathy. On logistic regression, gender (OR=0.241, 95% CI [0.079 – 0.735]) and misinformation (OR=0.280, 95% CI [0.081 – 0.974]) were significant predictors of uptake of screening. Uptake of diabetic retinopathy screening was sub-optimal. Gender and misinformation were significant barriers to uptake of screening. There is need to address barriers to uptake of retinopathy screening to promote timely identification and management of complications in people with diabetes mellitus.

Highlights

  • The prevalence of diabetes in Zimbabwe has increased significantly in the past three decades posing serious challenges to the provision of care and prevention of disabling co-morbidities in an already disadvantaged healthcare setting [1]

  • According to WHO, diabetic retinopathy is an important cause of blindness which results from long term accumulated damage to the small blood vessels in the retina and 2.6% of global blindness is attributed to diabetes

  • A greater proportion of participants who were not screened for diabetic retinopathy were females 16(59.3%) and gender was significantly associated with uptake of screening (p=0.029)

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Summary

Introduction

The prevalence of diabetes in Zimbabwe has increased significantly in the past three decades posing serious challenges to the provision of care and prevention of disabling co-morbidities in an already disadvantaged healthcare setting [1]. According to WHO, diabetic retinopathy is an important cause of blindness which results from long term accumulated damage to the small blood vessels in the retina and 2.6% of global blindness is attributed to diabetes. It is the fifth commonest cause of blindness and is responsible for a disproportionately larger quantum of associated morbidity [3]. Pregnant women with diabetes need to have their eyes examined in the first trimester of pregnancy, with close monitoring throughout pregnancy and 1 year post-partum as pregnancy can quickly exacerbate underlying diabetic retinopathy [6]

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