The Prevalence and Pattern of Diabetic Retinopathy Among Adult Patients Using a Non-mydriatic Fundus Camera at Nyangabgwe Referral Hospital, Francistown, Botswana

Abstract

Background: Diabetic retinopathy is one of the leading causes of irreversible blindness globally. The growing prevalence of diabetes in Africa makes screening for the disease a priority since early detection and sufficient treatment prevent blindness. Broad objective: to determine the prevalence and pattern of DR among patients attending the diabetic clinic at Nyangagbwe Referral Hospital, Francistown, Botswana using a non-mydriatic fundus camera Study Design: hospital-based cross-sectional study Study setting: Diabetic clinic of Nyangabgwe referral hospital, Francistown, Botswana Participants: Patients clinically diagnosed with diabetes, aged 18 years and above. Data collection methods: A consecutive sampling method was used. Data was collected from 22nd May 2023 to 2nd June 2023 after obtaining informed consent from eligible participants. The questionnaire was administered, visual acuity was obtained, a slit lamp examination was done and retina photography was taken using a non-mydriatic fundus camera zeiss visual 500. After that, the fundus photos were graded using the clinical ETDRS grading system. Results: The majority of participants were females(68.4%). The average age was 57.4 years. The prevalence of DR was 21.1% ( 95%CI 15.3-28.2%). The majority of those with DR were aged 60-69 years (37.5%), were female (59.4%), and had tertiary education(34.4%). They were also pensioners(31.3%), had type 2 DM(87.5%), and were on either insulin only(34.4%) or oral hypoglycemics (34.4%). Per the ETDRS classification, a majority had No DR (78.9%), followed by mild NPDR(8.6%), moderate NPDR(7.9%), severe NPDR(1.3%), and PDR(3.3%). The most prevalent selected known risk factor for DR was duration of DM for more than 10 years(59.4%; p-value< 0.0001), HbA1c% >6.5% (87.5%, p-value=0.219), elevated BMI(68.8%; p-value=0.964), HTN(65.6%, p-value=0.681) and least were nephropathy (6.3% p-value=0.095 )and smoking(3.1% p-value=0.346).