Volume 6, Issue 4, July 2020, Page: 79-84
Diabetic Retinopathy and the Risk Factors in South Sudan: A Six Months Study
Kenneth Lado Sube, College of Medicine, University of Juba, Juba, South Sudan
Joseph Daniel Lako, College of Industrial and Applied Sciences, University of Juba, Juba, South Sudan
Wani Gindalang Mena, Department of Ophthalmology, Juba Teaching Hospital, Juba, South Sudan
Oromo Francis Seriano, College of Medicine, University of Juba, Juba, South Sudan
Ader Macar Ader, College of Medicine, University of Juba, Juba, South Sudan
Richard Lado Lako, Directorate of Research and Policy, National Ministry of Health, Juba, South Sudan
Charles Ochero Langoya, College of Medicine and Veterinary Sciences, University of Edinburgh, Edinburgh, UK
Anthony Yousepha Lasuba, College of Medicine, University of Juba, Juba, South Sudan
Justin Bruno Tongun, College of Medicine, University of Juba, Juba, South Sudan
Constatine Jervase Yak, Faculty of Medicine, University of Bahr El Ghazal, Wau, South Sudan
Received: Jul. 17, 2020;       Accepted: Jul. 30, 2020;       Published: Aug. 20, 2020
DOI: 10.11648/j.ijcems.20200604.15      View  170      Downloads  67
Background: Diabetes Mellitus (DM) remains as one of the global epidemic of Non Communicable Diseases. Diabetic Retinopathy (DR), as one of its complications, has a prevalence of 35.4% worldwide. Objective: The aim of this study was to determine the prevalence and risk factors for DR among DM patients attending Diabetic Clinic in Malakia Health Center, Juba, South Sudan. Design and Method: This was a prospective, cross-sectional study in which diabetic patients attending Diabetic clinic, Malakia Health Center, were recruited for a period of Six months. All Diabetic patients were included and their demographic data recorded. Clinical data of duration of diabetes and hypertension were noted. Their Visual acuity, Blood pressure, Height, Weight, and Random blood sugar were measured. Eyes were examined and anterior segment diseases diagnosed. Funduscopy was done to determine posterior segment diseases and DR classified. Data were entered into SPSS version 22, analyzed and results expressed in statistical tables. Any result of p<0.05 was considered statistically significant. Results: Out of 108 patients and 216 eyes examined, males were 55.6% (60) and females 44.4% (48) with ages ranging from 23 to 75yrs, mean age of 51.1yrs (SD+/10.67). Patients with age 46-65 years had the highest 64.8% (70) and 18-35 years as the lowest 6.5% (8) with p>0.05. Most of these patients 39.8% (43) were from Kator block residential area with p>0.05. Type I DM were 27.8% (30) and Type II 72.2% (78) with p>0.05. DR prevalence was 13% (28) with NPDR the highest 11.6% (25) and PDR the lowest 0.5% (1) with p<0.05. No DR was 64% (139). DME was 7.4% (16) and cataract 3.7% (8). Risk factors for DR among the patients showed that the highest duration of DM was in >5yrs 68.5% (74) with p>0.05, uncontrolled blood glucose was 81.5% (88) with p>0.05, known hypertensive was 48.1% (52), high blood pressure (>120/80 mmHg) was 43.5% (41) with p>0.05 and BMI (>30kg/m2 was 23.1% (25) with p<0.05. There were 12% (25), 20% (44), and 68% (147) eyes blind, visual impairment and normal respectively due DR and the other eye conditions (p<0.05). Chi-square test showed BMI, BP and visual acuity were the only strongly associated to DR with P values of 0.007, 0.001 and 0.000 respectively. Conclusion: The study had shown, for the first time in South Sudan, the prevalence of DR as 13% with some of its risk factors. This will influence policy makers to develop strategies to improve management of DM and DR in the country.
Diabetes Mellitus, Diabetic Retinopathy, Prevalence, Diabetic Clinic, South Sudan
To cite this article
Kenneth Lado Sube, Joseph Daniel Lako, Wani Gindalang Mena, Oromo Francis Seriano, Ader Macar Ader, Richard Lado Lako, Charles Ochero Langoya, Anthony Yousepha Lasuba, Justin Bruno Tongun, Constatine Jervase Yak, Diabetic Retinopathy and the Risk Factors in South Sudan: A Six Months Study, International Journal of Clinical and Experimental Medical Sciences. Vol. 6, No. 4, 2020, pp. 79-84. doi: 10.11648/j.ijcems.20200604.15
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Frank Cortez-Floris, Supercourse, Aging and Diabetes mellitus [online] Available form: http://www.pitt.edu/~super1/lecture/lec1921/031.htm.
World Health Organization (WHO), global report on diabetes. 2016: http://www.who.int.
D. Paul Cohen, 2002, Dirty Dozen Research (online) Availablefrom: http://www.cohenresearch.com/reports/isv03-27-02.pdf.
Bandello F, Lattanzio R, Zucchiatti L, Petrazzi G. Non-proliferative Diabetic Retinopathy page 19-63. chapter in book edited by Bandello F, Zarbin MA, Lattanzio R, Zucchiatti I. Clinical strategies in the management of diabetic retinopathy. Published in 2014 by Springer.
Lee R, Wong T Y, and Sabanayagam C. Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss. Eye and Vision (2015) 2: 17 DOI 10.1186/s40662-015-0026-2.
Sivaprasad S, Gupta B, Crosby-Nwaobi R, and Evans J. Prevalence of diabetic Retinopathy in various ethnic groups: A worldwide perspective. Surv Ophthalmol 57: 347-370, 2012.
WHO Global data on visual impairments 2010. www.who.int/blindness/GLOBALDATAFINALforweb.pdf.
Wilkinson CP, Ferris FL 3rd, Klein RE, Lee PP, Agardh CD, Davis M, Dills D, Kampik A, Pararajasegaram R, Verdaguer JT; Global Diabetic Retinopathy Project Group. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology 2003; 110 (9): 1677-1682.
Shaw JE, Sicree RA, Zimmet PZ: Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract 2010, 87: 4–14.
Hall V, et al., Diabetes in Sub Saharan Africa Epidemiology and public health implications. A systematic review. BMC Public Health, 2011. 11: 564. doi: 10.1186/1471-2458-11-564 PMID: 21756350.
Umoh V, and Abraham E: Prevalence of diabetic retinopathy in diabetes mellitus patients attending a tertiary eye clinic in Uyo South- South Nigeria. Ibom Medical Journal Vol. 6 No. 2 August, 2013.
Lawan A, Mohammed TB. Pattern of diabetic retinopathy in Kano, Nigeria. Ann Afr Med 2012; 11: 75-9.
Liu L, Wu J, Yue S, Geng J, Lian J, Teng W et al. Incidence Density and Risk Factors of Diabetic Retinopathy Within Type 2 Diabetes: A Five-Year Cohort Study in China (Report 1). International Journal of Environmental Research and Public Health. 2015; 12 (7): 7899-7909.
Ibrahim M: Impact of Age, Duration and Control of Diabetes on Risk of Diabetic Retinopathy among Sudanese Diabetic Patients in Khartoum, Sudan- 2016: Hospital based Cross-Sectional study International Journal of Sciences: Basic and Applied Research (IJSBAR) (2017) Volume 33, No 1, pp 68-75.
Chisha Y, Terefe W, Assefa H, Lakew S (2017) Prevalence and factors associated with diabetic retinopathy among diabetic patients at Arbaminch General Hospital, Ethiopia: Cross sectional study. PLoS ONE 12 (3): e0171987. doi: 10.1371/journal.pone.0171987.
Khandekar R, J Al Lawati, A. J Mohammad, A Al Raisi, 2003. Diabetic retinopathy in Oman; A hospital based study [online] Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmedandpubmedid=12928265.
C. R. Cleland et al: Diabetic retinopathy screening in Tanzania Tropical Medicine and International Health. volume 21 no 3 pp 417–426 march 2016.
Ahmed RA, Khalil SN, Al-Qahtani MA. Diabetic retinopathy and the associated risk factors in diabetes type 2 patients in Abha, Saudi Arabia. J Fam Community Med 2016; 23: 18-24.
Burgess PI, Allain TJ, García-Fiñana M, Beare NA, Msukwa G, Harding SP. High prevalence in Malawi of sight-threatening retinopathy and visual impairment caused by diabetes: identification of population-specific targets for intervention. Diabet Med 2014; 31 (12): 1643-1650.
Jingi AM, Noubiap JJ, Essouma M, Bigna JJ, Nansseu JR, Ellong A, Mvogo CE. Association of insulin treatment versus oral hypoglycaemic agents with diabetic retinopathy and its severity in type 2 diabetes patients in Cameroon, sub-Saharan Africa. Ann Transl Med 2016; 4 (20): 395.
Ting DS, Cheung GC, Wong TY. Diabetic retinopathy: global prevalence, major risk factors, screening practices and public health challenges: a review. Clin Exp Ophthalmol 2016; 44 (4): 260-277.
YAU J W. et al: Global prevalence and risk factors of Diabetic Retinopathy. DIABETES CARE, VOLUME 35, MARCH 2012.
Sharew G, Ilako DR, Kimani K, Gelaw Y. Prevalence of diabetic retinopathy in Jimma University Hospital, Southwest Ethiopia. Ethiop Med J 2013; 51 (2): 105-113.
Mathenge W, Bastawrous A, Peto T, Leung I, Yorston D, Foster A, Kuper H. Prevalence and correlates of diabetic retinopathy in a population-based survey of older people in Nakuru, Kenya. Ophthalmic Epidemiol 2014; 21 (3): 169-177.
Ashaye A, Arije A, Kuti M, Olusanya B, Ayeni E, Fasanmade A et al. retinopathy among type 2 diabetic patients seen at a tertiary hospital in Nigeria: a preliminary report. ClinOphthalmol 2008March; 2 (1): 103-108.
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