Screening for diabetic retinopathy at a health centre in South Africa: A cross-sectional study
Background: In South Africa, screening for diabetic retinopathy (DR) is non-existent at the primary healthcare (PHC) level because of the absence of a screening programme. This leads to preventable vision loss. Aim: To describe the clinical characteristics and outcomes of eye screenings and subsequ...
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| Language: | English |
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AOSIS
2025-01-01
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| Series: | Journal of Public Health in Africa |
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| Online Access: | https://publichealthinafrica.org/index.php/jphia/article/view/681 |
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| author | Ntokozo Zulu Patrick Ngassa Piotie Elizabeth M. Webb Wezi G. Maphenduka Steve Cook Paul Rheeder |
| author_facet | Ntokozo Zulu Patrick Ngassa Piotie Elizabeth M. Webb Wezi G. Maphenduka Steve Cook Paul Rheeder |
| author_sort | Ntokozo Zulu |
| collection | DOAJ |
| description | Background: In South Africa, screening for diabetic retinopathy (DR) is non-existent at the primary healthcare (PHC) level because of the absence of a screening programme. This leads to preventable vision loss.
Aim: To describe the clinical characteristics and outcomes of eye screenings and subsequent referrals.
Setting: Laudium Community Health Centre (CHC), a PHC facility in Tshwane.
Methods: We conducted a cross-sectional study from February 2022 to August 2022. Individuals with diabetes were screened for eye complications using visual acuity testing, intraocular pressure measurement, and fundoscopy with a non-mydriatic digital fundus camera. Fundus images were analysed by an optometrist and an artificial intelligence (AI) programme. Demographic and clinical data were collected.
Results: A total of 120 participants were included, with the majority (60.7%) from Laudium CHC. Most participants (64.2%) were on oral agents, and 66.7% were women. The mean haemoglobin A1c (HbA1c) was 8.3%, with a median diabetes duration of 8 years. Artificial intelligence detected more glaucoma cases (17.5% vs 9.2%) and DR (23.3% vs 15.8%) compared to the optometrist. In contrast, the optometrist identified more cases of macula pathology (29.2% vs 19.2%). Participants (n = 79) were referred to an ophthalmologist for diagnosis confirmation and management.
Conclusion: The study revealed that while DR was not highly prevalent among PHC patients with diabetes, there was a significant referral rate for other ocular complications. Artificial intelligence can enhance early detection and improve efficiency.
Contribution: The findings underscore the need to integrate diabetes eye screening programmes into PHC services for people living with diabetes. |
| format | Article |
| id | doaj-art-1977587c36234797a7ff16938292077f |
| institution | Kabale University |
| issn | 2038-9922 2038-9930 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | AOSIS |
| record_format | Article |
| series | Journal of Public Health in Africa |
| spelling | doaj-art-1977587c36234797a7ff16938292077f2025-02-11T13:24:50ZengAOSISJournal of Public Health in Africa2038-99222038-99302025-01-01161e1e610.4102/jphia.v16i1.681780Screening for diabetic retinopathy at a health centre in South Africa: A cross-sectional studyNtokozo Zulu0Patrick Ngassa Piotie1Elizabeth M. Webb2Wezi G. Maphenduka3Steve Cook4Paul Rheeder5School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, PretoriaSchool of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria; and, University of Pretoria Diabetes Research Centre, Faculty of Health Sciences, University of Pretoria, PretoriaSchool of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria; and, University of Pretoria Diabetes Research Centre, Faculty of Health Sciences, University of Pretoria, PretoriaDepartment of Ophthalmology, Faculty of Health Sciences, University of Pretoria, PretoriaThe Eye Centre, East London; and, Department of Ophthalmology, Faculty of Medicine and Health Sciences, Walter Sisulu University, East LondonUniversity of Pretoria Diabetes Research Centre, Faculty of Health Sciences, University of Pretoria, Pretoria; and, Department of Internal Medicine, Faculty of Health Sciences, University of Pretoria, PretoriaBackground: In South Africa, screening for diabetic retinopathy (DR) is non-existent at the primary healthcare (PHC) level because of the absence of a screening programme. This leads to preventable vision loss. Aim: To describe the clinical characteristics and outcomes of eye screenings and subsequent referrals. Setting: Laudium Community Health Centre (CHC), a PHC facility in Tshwane. Methods: We conducted a cross-sectional study from February 2022 to August 2022. Individuals with diabetes were screened for eye complications using visual acuity testing, intraocular pressure measurement, and fundoscopy with a non-mydriatic digital fundus camera. Fundus images were analysed by an optometrist and an artificial intelligence (AI) programme. Demographic and clinical data were collected. Results: A total of 120 participants were included, with the majority (60.7%) from Laudium CHC. Most participants (64.2%) were on oral agents, and 66.7% were women. The mean haemoglobin A1c (HbA1c) was 8.3%, with a median diabetes duration of 8 years. Artificial intelligence detected more glaucoma cases (17.5% vs 9.2%) and DR (23.3% vs 15.8%) compared to the optometrist. In contrast, the optometrist identified more cases of macula pathology (29.2% vs 19.2%). Participants (n = 79) were referred to an ophthalmologist for diagnosis confirmation and management. Conclusion: The study revealed that while DR was not highly prevalent among PHC patients with diabetes, there was a significant referral rate for other ocular complications. Artificial intelligence can enhance early detection and improve efficiency. Contribution: The findings underscore the need to integrate diabetes eye screening programmes into PHC services for people living with diabetes.https://publichealthinafrica.org/index.php/jphia/article/view/681diabetic retinopathyscreeningprimary carediabetesnon-mydriatic photographyaimicrovascular complicationsfundus camera. |
| spellingShingle | Ntokozo Zulu Patrick Ngassa Piotie Elizabeth M. Webb Wezi G. Maphenduka Steve Cook Paul Rheeder Screening for diabetic retinopathy at a health centre in South Africa: A cross-sectional study Journal of Public Health in Africa diabetic retinopathy screening primary care diabetes non-mydriatic photography ai microvascular complications fundus camera. |
| title | Screening for diabetic retinopathy at a health centre in South Africa: A cross-sectional study |
| title_full | Screening for diabetic retinopathy at a health centre in South Africa: A cross-sectional study |
| title_fullStr | Screening for diabetic retinopathy at a health centre in South Africa: A cross-sectional study |
| title_full_unstemmed | Screening for diabetic retinopathy at a health centre in South Africa: A cross-sectional study |
| title_short | Screening for diabetic retinopathy at a health centre in South Africa: A cross-sectional study |
| title_sort | screening for diabetic retinopathy at a health centre in south africa a cross sectional study |
| topic | diabetic retinopathy screening primary care diabetes non-mydriatic photography ai microvascular complications fundus camera. |
| url | https://publichealthinafrica.org/index.php/jphia/article/view/681 |
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