Chisha Yilma, Terefe Wondwossen, Assefa Huruy, Lakew Serawit
Department of Biostatistics and health informatics, Arbaminch College of Health Sciences, Arbaminch, Ethiopia.
Departement of Biostatistics, Mekelle University, Mekelle, Ethiopia.
PLoS One. 2017 Mar 2;12(3):e0171987. doi: 10.1371/journal.pone.0171987. eCollection 2017.
Currently 93 million people are estimated as living with diabetic retinopathy worldwide. The prevalence and risk factors of diabetic retinopathy in developed countries have been well documented; but in Ethiopia, data on prevalence and associated factors of diabetic retinopathy is lacking.
To determine prevalence and factors associated with development of diabetic retinopathy among diabetic patients at Arbaminch General Hospital, Ethiopia.
Cross-sectional study design with record review of 400 diabetic patients was conducted at Arbaminch General Hospital from November to January 2015. Among 400 diabetic patients, 270 patients with baseline information and without history of hypertension at baseline were included in this study. But patients with gestational diabetes and with retinopathy at baseline were excluded from the study. Consecutive sampling technique was applied to select study participants. Data of cohorts was extracted from medical record using pre tested structured extraction check list. Data cleaning, coding, categorizing, merging and analysis carried out by STATA version 12. Descriptive statistics was done and presented accordingly. Bivariate binary logistic regression analysis was done to select potential candidates for the full model at P-value cutoff point ≤ 0.25 and multivariable binary logistic regression analysis was made to estimate the independent effect of predictors on the occurrence of diabetic retinopathy. Model diagnostic tests were done, final model fitness was checked using Hosmer and Lemeshow chi square test. Finally, statistical significance was tested at P-value <0.05.
Prevalence of diabetic retinopathy among diabetic patients at Arbaminch General Hospital was 13%. Adjusted analysis showed that the odds of diabetic retinopathy were statistically and significantly associated with baseline age (AOR = 6.06: 95%CI; 2.42, 15.21), baseline systolic blood pressure level (AOR = 4.38: 95%CI; 1.64, 11.68), family history of diabetes (AOR = 0.22: 95%CI; 0.08, 0.58) and duration of diabetes (AOR = 8.84: 95%CI; 3.56, 12.89).
In the current study, prevalence of diabetic retinopathy was 13%. Since baseline age ≥60 years, baseline systolic blood pressure level >140 mmhg, duration of diabetes ≥6 years and patients with family history of diabetes were statistically and significantly related with diabetic retinopathy, special care should be given in addition to routine care.
据估计，目前全球有9300万人患有糖尿病视网膜病变。发达国家糖尿病视网膜病变的患病率和危险因素已有充分记录；但在埃塞俄比亚，缺乏糖尿病视网膜病变患病率及相关因素的数据。
确定埃塞俄比亚阿巴明奇综合医院糖尿病患者中糖尿病视网膜病变的患病率及相关因素。
2015年11月至1月在阿巴明奇综合医院采用横断面研究设计并回顾400例糖尿病患者的记录。在400例糖尿病患者中，本研究纳入了270例有基线信息且基线时无高血压病史的患者。但基线时患有妊娠期糖尿病和视网膜病变的患者被排除在研究之外。采用连续抽样技术选择研究参与者。使用预先测试的结构化提取检查表从病历中提取队列数据。数据清理、编码、分类、合并和分析由STATA 12版完成。进行描述性统计并相应呈现。进行双变量二元逻辑回归分析以在P值截止点≤0.25时选择全模型的潜在候选变量，并进行多变量二元逻辑回归分析以估计预测因素对糖尿病视网膜病变发生的独立影响。进行模型诊断测试，使用Hosmer和Lemeshow卡方检验检查最终模型的拟合度。最后，在P值<0.05时检验统计学显著性。
阿巴明奇综合医院糖尿病患者中糖尿病视网膜病变的患病率为13%。校正分析表明，糖尿病视网膜病变的几率在统计学上与基线年龄（调整后比值比[AOR]=6.06：95%置信区间[CI]；2.42，15.21）、基线收缩压水平（AOR = 4.38：95%CI；1.64，11.68）、糖尿病家族史（AOR = 0.22：95%CI；0.08，0.58）和糖尿病病程（AOR = 8.84：95%CI；3.56，12.89）显著相关。
在本研究中，糖尿病视网膜病变的患病率为13%。由于基线年龄≥60岁、基线收缩压水平>140 mmHg、糖尿病病程≥6年以及有糖尿病家族史的患者与糖尿病视网膜病变在统计学上显著相关，除常规护理外，应给予特别护理。
