title: Diabetic retinopathy in Africa: advantages of screening.
abstract: OBJECTIVE
  To review the epidemiology of diabetic retinopathy (DR) in Africa and discuss the various methods of screening for the disease.
  
  
  METHODS
  Review of the peer-reviewed articles in PubMed, Google, and Scirus about DR published from 1985 to 2010. Articles in all languages were considered, provided that the non-English articles included English abstracts.
  
  
  RESULTS
  Screening for DR can significantly prevent the loss of vision resulting from long-standing diabetes mellitus. Screening is also financially advantageous for both patients and health care systems. Several screening methods can be employed by primary care providers, who over the past 20 years have become responsible for the treatment and follow-up of patients with diabetes rather than hospitals. An additional concern for screening in African countries is the inefficient referral to ophthalmologists, given their scarce distribution in the African population. Finally, education of both the patient population and caregivers should be included as an essential component of screening programs.
  
  
  CONCLUSIONS
  As of now, African health care systems are not prepared to deal with the increasing burden of diabetes and its complications. With inappropriate glycemic or blood pressure control, most patients will only seek care once micro- or macrovascular complications have already developed. Given the current difficulty in providing costly therapeutic interventions, a well-planned, cost-effective prevention strategy is required.
authors.affiliation: Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Sarah
authors.initials: S
authors.lastname: Guigui
authors.forename: Tova
authors.initials: T
authors.lastname: Lifshitz
authors.forename: Jaime
authors.initials: J
authors.lastname: Levy
mesh_terms: D000349:Africa / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010353:Patient Education as Topic