title: Diabetic retinopathy in Tanzania: prevalence and risk factors at entry into a regional screening programme.
abstract: OBJECTIVE
  The number of adults with diabetes in sub-Saharan Africa (SSA) is expected to almost double by 2035. This study investigated the prevalence of diabetic retinopathy (DR) and its risk factors at entry into a community-based screening programme.
  
  
  METHODS
  All persons with diabetes screened for retinopathy at entry into a screening programme in Kilimanjaro Region, Tanzania between November 2010 and December 2014 were included. Fundus photographs were taken with a Topcon retinal camera following pupil dilation. Data were collected on BP, random blood sugar, duration of diabetes, BMI and visual acuity on entry.
  
  
  RESULTS
  A total of 3187 persons were screened for DR. The prevalence of any DR was 27.9% (95%CI 26.4-29.5%) with background diabetic retinopathy (BDR), pre-proliferative diabetic retinopathy (PPDR) and proliferative diabetic retinopathy (PDR) having a prevalence of 19.1% (95% CI 17.7-20.4%), 6.0% (95%CI 5.2-6.8%) and 2.9% (95%CI 2.3-3.5%), respectively. Maculopathy was present in 16.1% (95%CI 14.8-17.4%) of participants. Multivariable logistic regression analysis for the presence of any DR found independent associations with duration of diabetes (P < 0.0001), systolic BP (P < 0.0001), random blood sugar (P < 0.0001) and attending a government hospital diabetic clinic (P = 0.0339).
  
  
  CONCLUSIONS
  This study is the first to present data from a DR screening programme in SSA. The results will provide policymakers with data to aid planning of DR screening and treatment services in the African region. The study highlights the importance of managing comorbidities within DR screening programmes.
authors.affiliation: Eye Department, Kilimanjaro Christina Medical Centre, Moshi, Tanzania.
authors.forename: Charles R
authors.initials: CR
authors.lastname: Cleland
authors.affiliation: International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Burton
authors.affiliation: Faculty of Psychology and Neuroscience, University Maastricht, Maastricht, The Netherlands.
authors.forename: Claudette
authors.initials: C
authors.lastname: Hall
authors.affiliation: Newcastle Eye Hospital Research Foundation, Waratah, NSW, Australia.
authors.forename: Anthony
authors.initials: A
authors.lastname: Hall
authors.affiliation: Kilimanjaro Centre for Community Ophthalmology, University of Cape Town, Cape Town, South Africa.
authors.forename: Paul
authors.initials: P
authors.lastname: Courtright
authors.affiliation: Eye Department, Kilimanjaro Christina Medical Centre, Moshi, Tanzania.
authors.forename: William U
authors.initials: WU
authors.lastname: Makupa
authors.affiliation: Eye Department, Kilimanjaro Christina Medical Centre, Moshi, Tanzania.|International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Heiko
authors.initials: H
authors.lastname: Philippin
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D003930:Diabetic Retinopathy / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D013636:Tanzania / Q000453:epidemiology; D014792:Visual Acuity
chemical_list: D001786:Blood Glucose
keywords: Africa; Afrique; cribado; diabetic retinopathy; dépistage; retinopatía diabética; rétinopathie diabétique; screening; África