Utilization of eye health services and diabetic retinopathy: a cross-sectional study among persons living with diabetes visiting a tertiary eye care facility in Ghana

Abstract

Background There have been a major advance made in screening, early diagnosis, and prompt treatment of Diabetic Retinopathy among Person living with diabetes (PLWD). However, screening services remain a challenge in Low-Middle-Income-Countries where access to eye care professionals is inadequate. This study assesses the utilization of Eye Health Service prevalence (UEHS) among PLWD and associated factors and further quantifies its association with Non-Proliferative Diabetic Retinopathy (NPDR). Methods A cross-sectional study design with a random sample of 360 PLWD was conducted at Korle-Bu Teaching Hospital, a National Referral Centre in Ghana from May to July 2019. UEHS and DR were the study outcomes. We adopted Poisson and Probit regression analysis to assess factors associated with UEHS over the past year. We employed pairwise and phi correlation (fourfold correlational analysis) to assess the relationship between UEHS and DR (ordinal and binary respectively). Ordered Logistic and Poisson regression were applied to assess the association between the UEHS and DR. Stata 16.1 was used to perform the analyses and a p-value ≤ 0.05 was deemed significant. Results The prevalence of UEHS over the past year and DR was 21.7 %(95 %CI = 17.7–26.2) and 65.0 %(95 %CI = 59.9–69.8 respectively. The prevalence of severe NPDR with Clinically Significant Macular Edema (CSME) was 23.9 %(19.8–28.6). Type of diabetes, increasing age, educational level, mode of payment for healthcare services, marital status, years since diagnosis, and current blood glucose significantly influenced UEHS. There was a negative relationship between DR and UEHS (Pairwise and φ correlation were − 20 and − 15 respectively; p < 0.001). Non-UEHS among PLWD doubles the likelihood of experiencing severe NPDR with CSME compared with UEHS among PLWD [aOR(95 %CI) = 2.05(1.03–4.08)]. Meanwhile, the prevalence of DR among patients per non-UEHS was insignificantly higher [12 %; aPR(95 %CI) = 0.89–1.41)] compared with patients who utilized eye care health service. Conclusions Most of the PLWD did not utilize the eye health service even once in a year and that was highly influenced by type of diabetes and increasing age. Type 2 diabetes patients and middle age decreased the likelihood of UEHS. There was a negative relationship between DR and UEHS among PLWD and this doubled the likelihood of experiencing severe NPDR with CSME. Structured health education and screening interventions are key to improving UEHS.

Prevalence and factors associated with Diabetes retinopathy among type 2 diabetic patients at Northwest Amhara Comprehensive Specialized Hospitals, Northwest Ethiopia 2021

“…The odds of diabetic retinopathy for diabetic patients who visit health institutions for their diabetic case every month had about 2.7% [AOR = 0.025, 95% CI (0.003, 0.253)] less chance diabetic retinopathy than those patients who visit health institutions for their diabetic case every six months. A similar finding was reported in a study conducted in Ghana [ 30 ].This may be due to, most diabetic patients in this study being appointed every 6 months and more. This contributes to poor glycemic control.…”

Eye care service utilization and associated factors among diabetic patients in Africa: A Systematic Review and Meta-Analysis

“…The included articles were published between 2007 and 2022. From the included articles 3 studies are from Ethiopia [ [34] , [35] , [36] ], 2 are from Nigeria [ 23 , 37 ] and the remaining are from South Africa, Kenya, Ghana and Tanzania [ [38] , [39] , [40] , [41] ]. All the studies published in peer-reviewed journals ( Table 1 ).…”

Visual impairment among diabetes patients in Ethiopia: A systematic review and meta-analysis

“…Diabetes mellitus (DM) is a major global public health problem [1]. It was one of the four priority non-communicable diseases (NCDs) targeted for prevention and control in 2011 [2].…”