Diabetic Retinopathy and Associated Factors in Patients with Diabetes Mellitus at Muhimbili National Hospital

Abstract

Background; Diabetes mellitus(DM) is a non communicable disease and chronic metabolic disorder, regarded as an important public health problem . Globally affects 463 million people with DM . Diabetic retinopathy is a sight threatening microvascuar cmplication of diabetes mellitus. Causing visual impairment in 2.6 million and blindness in 2.52 million people, predicted to double by the year 2030. Blindness related to diabetic retinopathy is projected to increase in developing world including Tanzania. However several factors are associated directly or indirectly involved in the development and progression of DR, evidence suggested that good control of the associated factors reduces the risk of DR. The diabetic clinic at the Muhimbili National Hospital attends an average of 75 patients per clinic day, potentially all are at risk of developing DR. Despite having many patients presenting to the diabetic clinic, the last study done on factors associated with DR at MNH was in 1990. The time since this last study done is long enough for relaying on its report ,hence there was a need of evaluating current information of these factors. Aim; The aim of this study was to provide current information on prevalence and associated factors for DR. Methodology: A cross section descriptive hospital based study was conducted at Muhimbili national hospital at diabetic clinic,from May to June 2021. Including 370 participants, all were adults 18 years and above DM patients. They were selected through systematic sampling technique .Clinical history, systemic and ocular examination (retinopathy screening) was done. A structured questionnaire was used to collect information on clinical and laboratory findings. Analysis was done using SPSS. Binary logistic regression followed by multiple logistic regression analysis was conducted to identify associated factors. Result; There were 39.9% participants with DR. Participants with age <40 had only 2.7% of DR. Peasants were found with less proportion compared to employed (1.7%,51,4%) respectivey. Employed were about three times likely to develop DR than peasants (AoR 2.68(95%CI1.47- 4.88), duration (>10years DM) participants were 2.5 times likely to have DR than those with less than 10 years of DM (AoR 2.53 (95%CI 1.5-4.10) and participants in moderate glycaemic control (6-8%) HbA1c were twice likely to develop DR (AoR 2.8(95%CI 1.025.- 5.12) than those with the normal range(<6%), level of no formal/pimary education found to have 2.21 Odd (AoR 2.21(95%CI 11.114.39) of developing DR than those with collage level of education. While participants with hypertension had significant association with DR with an odd ratio of nearly twice of the non hypertensive. (AoR 1.86 (95% CI 1.11-3.11). Conclusion; More than a quarter of the participants had diabetic retinopathy were office working employed particiants, duration of illness, glycaemic control, low level of education and hypertension were significantly associated with DR.