Jawa Ali, Assir Muhammad Zaman Khan, Riaz Syed Hunain, Chaudhary Rashin, Awan Farooq, Akram Javed
Prof. Ali Jawa, MD, MPH, DABIM, FACE. Shaheed Zulfiqar Ali Bhutto Medical University, PIMS, Islamabad, Pakistan.
Muhammad Zaman Khan Assir, FCPS. Shaheed Zulfiqar Ali Bhutto Medical University, PIMS, Islamabad, Pakistan.
Pak J Med Sci. 2016 Sep-Oct;32(5):1102-1106. doi: 10.12669/pjms.325.10955.
To find out prevalence of Diabetic Retinopathy in general population of three districts in Pakistan.
A community based cross-sectional survey was conducted in three large districts of Pakistan namely Rawalpindi in Punjab, Peshawar in Khyber Pakhtoonkhwa and Hyderabad in Sindh between January 2013 and August 2015. Lady Health Workers identified individuals at high risk for diabetes based on pre-defined criteria. High risk population was tested for dysglycemia. Fundoscopic evaluation for evidence of DR was performed in all individuals with a random blood glucose >190mg/dl. Individuals with the evidence of DR were referred to affiliated tertiary care ophthalmology departments.
A total of 42,629 individuals reported at the project sites and 63% (n=26,859) were female. Fifty one percent (n=21,989) individuals met high risk criteria. Out of these 21,989 individuals, dysglycemia was found in 3,869 (17.6%). Fundoscopy showed evidence of DR in 1,042 (27%) individuals. Amongst high risk population, dysglycemia was significantly more common in females as compared to males. The frequency of DR in dysglycemic patients was comparable across both gender groups.
The prevalence of DR in Pakistani population is alarmingly high. This preventable cause of blindness is largely undiagnosed in our population and a simple integrated model based on primary health care facilities can help identify and treat a large population of DR patients.
了解巴基斯坦三个地区普通人群中糖尿病视网膜病变的患病率。
2013年1月至2015年8月期间，在巴基斯坦的三个大地区开展了一项基于社区的横断面调查，这三个地区分别是旁遮普省的拉瓦尔品第、开伯尔-普赫图赫瓦省的白沙瓦以及信德省的海得拉巴德。女性卫生工作者根据预先设定的标准识别出糖尿病高危个体。对高危人群进行血糖异常检测。对所有随机血糖>190mg/dl的个体进行眼底镜检查，以评估是否有糖尿病视网膜病变的迹象。有糖尿病视网膜病变迹象的个体被转诊至附属的三级眼科护理科室。
共有42629人到项目地点报到，其中63%（n = 26859）为女性。51%（n = 21989）的个体符合高危标准。在这21989名个体中，发现3869人（17.6%）存在血糖异常。眼底镜检查显示1042人（27%）有糖尿病视网膜病变迹象。在高危人群中，女性血糖异常的情况比男性更为常见。血糖异常患者中糖尿病视网膜病变的发生率在两个性别组中相当。
巴基斯坦人群中糖尿病视网膜病变的患病率高得惊人。这种可预防的失明原因在我国人群中大多未被诊断出来，一个基于初级卫生保健设施的简单综合模式有助于识别和治疗大量糖尿病视网膜病变患者。
