Prevalence of Diabetic Retinopathy and Its Associated Factors among Diabetic Patients at Debre Markos Referral Hospital, Northwest Ethiopia, 2019: Hospital-Based Cross-Sectional Study

Abstract

Background

Diabetic retinopathy is a well-known sight-threatening microvascular complication of diabetes mellitus. Currently, 93 million people live with diabetic retinopathy worldwide. There are insufficient studies addressing the prevalence of diabetic retinopathy and risk factors in Ethiopia.

Objective

To assess the prevalence of diabetic retinopathy and its associated factors among diabetic patients on follow-up at Debre Markos Referral Hospital, northwest Ethiopia, 2019.

Methods

This institution- based cross-sectional study was conducted among 302 patients. They were selected through systematic sampling. Explanatory data were extracted from medical records and interviews. Blood pressure, weight, height, and visual acuity tests were assessed. Retinal examination was performed with a Topcon TRC-NW7SF fundus camera. Data were entered in EpiData 3.1 and exported in to SPSS 20 for analyses. Binary logistic regression with 95% CIs was used for analyses. Simple binary logistic regression followed by multiple binary logistic regression analysis was conducted to identify associated factors.

Results

There were 302 patients in this study, of which 57 (18.9%) had diabetic retinopathy. Among the diabetic retinopathy patients, 75.4% had the preproliferative type. Four in ten (37.7%) of the patients had visual acuity problems. Poor glycemic control (AOR 4.58, 95% CI 1.86–11.31), > 10 years’ diabetes duration (AOR 3.91, 95% CI 1.86–8.23), body-mass index >25 kg/m² (AOR 3.74, 95% CI 1.83–7.66), and hypertension (AOR 3.39, 95% CI 1.64–7.02) were factors significantly associated with diabetic retinopathy.

Conclusion

About a-fifth of diabetic patients had diabetic retinopathy. Diabetic retinopathy was significantly associated with glycemic control, hypertension, body-mass index, and duration of illness. Routine assessment and early control of those associated factors may be important in reducing both the prevalence and impact of diabetic retinopathy, as evidenced in the current study.

Keywords:

• diabetes mellitus
• diabetic retinopathy
• associated factor
• Ethiopia

Abbreviations

AOR, adjusted OR; BMI, body-mass index; COR, crude oOR; DM, diabetes mellitus; DR, diabetic retinopathy; FBS, fasting blood sugar; IRMAs, intraretinal microvascular abnormalities; NGO, nongovernmental organization; NPDR, nonproliferative dDRr; PDR, proliferative DR; SBP, systolic blood pressure; SLB, slit-lamp biomicroscopy; WHO, World Health Organization.

Data-Sharing Statement

The authors confirm that all data underlying the findings are fully available without restriction. All relevant data are within the manuscript.

Ethics Approval and Consent to Participate

This study was performed in accordance with the revised Declaration of Helsinki guidelines for biomedical research involving human subjects,⁴⁵ and ethical clearance was obtained from the Institutional Review Board, College of Health Science, and Jimma University. Following endorsement from the university, Debre Markos Referral Hospital (study setting) was informed about the objectives of the study through a support letter from the Institutional Review Board. After obtaining informed consent (oral) from clients, data were collected. Study participants had the right to refuse to join, ask any question, or withdraw at any time. Privacy and confidentiality were assured. Respondents who were diagnosed with retinopathy were referred to the ophthalmic clinic for further management.

Consent for Publication

Not applicable.

Acknowledgments

The authors would like to thank Debre Markos Referral Hospital administration, health workers, and data collectors. We are also indebted to the study participants for their kind cooperation.

Author Contributions

All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data, took part in drafting the article or revising it critically for important intellectual content, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

All the authors declare that they have no competing interests.

Additional information

Funding

There was no funding or sponsoring organization for this study.