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Uptake of diabetic retinopathy screening at a secondary level facility in Malawi

Diabetic retinopathy (DR) is a common microvascular complication of long-standing diabetes mellitus (DM). DR screening is a cost-effective intervention for preventing blindness from DR. We conducted a cross-sectional study to investigate the uptake and the predictors of uptake of annual DR screening...

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Autores principales: Zungu, Thokozani, Mdala, Shaffi, Kayange, Petros, Fernando, Elizabeth, Twabi, Halima, Jumbe, Arnold, Kumwenda, Johnstone, Muula, Adamson
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10631633/
https://www.ncbi.nlm.nih.gov/pubmed/37939026
http://dx.doi.org/10.1371/journal.pgph.0002567
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author Zungu, Thokozani
Mdala, Shaffi
Kayange, Petros
Fernando, Elizabeth
Twabi, Halima
Jumbe, Arnold
Kumwenda, Johnstone
Muula, Adamson
author_facet Zungu, Thokozani
Mdala, Shaffi
Kayange, Petros
Fernando, Elizabeth
Twabi, Halima
Jumbe, Arnold
Kumwenda, Johnstone
Muula, Adamson
author_sort Zungu, Thokozani
collection PubMed
description Diabetic retinopathy (DR) is a common microvascular complication of long-standing diabetes mellitus (DM). DR screening is a cost-effective intervention for preventing blindness from DR. We conducted a cross-sectional study to investigate the uptake and the predictors of uptake of annual DR screening in an opportunistic DR screening programme at a secondary-level diabetes clinic in Southern Malawi. Consecutive patients were interviewed using a structured questionnaire to record their demographic characteristics, medical details and data regarding; the frequency of clinic visits, knowledge of existence of DR screening services and a history of referral for DR screening in the prior one year. Univariate binary logistic regression was used to investigate predictors of DR screening uptake over the prior one year. Explanatory variables that had a P-value of < 0.1 were included into a multivariate logistic regression model. All variables that had a p-value of <0.05 were considered to be statistically significant. We recruited 230 participants over three months with a median age of 52.5 years (IQR 18–84) and a median duration of diabetes of 4 years (IQR 1–7). The average interval of clinic visits was 1.2 months (SD ± 0.43) and only 59.1% (n = 139) of the participants were aware of the existence of diabetic retinopathy screening services at the facility. The uptake for DR screening over one year was 20% (n = 46). The strongest predictors of uptake on univariate analysis were awareness of the existence of DR screening services (OR 10.05, P <0.001) and a history of being referred for DR screening (OR 9.02, P <0.001) and these remained significant on multivariable analysis. Interventions to improve uptake for DR screening should promote referral of patients for DR screening and strengthen knowledge about the need and availability of DR screening services.
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spelling pubmed-106316332023-11-08 Uptake of diabetic retinopathy screening at a secondary level facility in Malawi Zungu, Thokozani Mdala, Shaffi Kayange, Petros Fernando, Elizabeth Twabi, Halima Jumbe, Arnold Kumwenda, Johnstone Muula, Adamson PLOS Glob Public Health Research Article Diabetic retinopathy (DR) is a common microvascular complication of long-standing diabetes mellitus (DM). DR screening is a cost-effective intervention for preventing blindness from DR. We conducted a cross-sectional study to investigate the uptake and the predictors of uptake of annual DR screening in an opportunistic DR screening programme at a secondary-level diabetes clinic in Southern Malawi. Consecutive patients were interviewed using a structured questionnaire to record their demographic characteristics, medical details and data regarding; the frequency of clinic visits, knowledge of existence of DR screening services and a history of referral for DR screening in the prior one year. Univariate binary logistic regression was used to investigate predictors of DR screening uptake over the prior one year. Explanatory variables that had a P-value of < 0.1 were included into a multivariate logistic regression model. All variables that had a p-value of <0.05 were considered to be statistically significant. We recruited 230 participants over three months with a median age of 52.5 years (IQR 18–84) and a median duration of diabetes of 4 years (IQR 1–7). The average interval of clinic visits was 1.2 months (SD ± 0.43) and only 59.1% (n = 139) of the participants were aware of the existence of diabetic retinopathy screening services at the facility. The uptake for DR screening over one year was 20% (n = 46). The strongest predictors of uptake on univariate analysis were awareness of the existence of DR screening services (OR 10.05, P <0.001) and a history of being referred for DR screening (OR 9.02, P <0.001) and these remained significant on multivariable analysis. Interventions to improve uptake for DR screening should promote referral of patients for DR screening and strengthen knowledge about the need and availability of DR screening services. Public Library of Science 2023-11-08 /pmc/articles/PMC10631633/ /pubmed/37939026 http://dx.doi.org/10.1371/journal.pgph.0002567 Text en © 2023 Zungu et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Zungu, Thokozani
Mdala, Shaffi
Kayange, Petros
Fernando, Elizabeth
Twabi, Halima
Jumbe, Arnold
Kumwenda, Johnstone
Muula, Adamson
Uptake of diabetic retinopathy screening at a secondary level facility in Malawi
title Uptake of diabetic retinopathy screening at a secondary level facility in Malawi
title_full Uptake of diabetic retinopathy screening at a secondary level facility in Malawi
title_fullStr Uptake of diabetic retinopathy screening at a secondary level facility in Malawi
title_full_unstemmed Uptake of diabetic retinopathy screening at a secondary level facility in Malawi
title_short Uptake of diabetic retinopathy screening at a secondary level facility in Malawi
title_sort uptake of diabetic retinopathy screening at a secondary level facility in malawi
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10631633/
https://www.ncbi.nlm.nih.gov/pubmed/37939026
http://dx.doi.org/10.1371/journal.pgph.0002567
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