孟加拉国农村地区参与糖尿病视网膜病变筛查计划的相关因素。
Factors associated with participation in a diabetic retinopathy screening program in a rural district in Bangladesh.
机构信息
Department of Statistics, Data Science and Epidemiology, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC 3122, Australia; Organisation for Rural Community Development (ORCD), Dariapur, Narail, Bangladesh.
Department of Vision Informatics (Topcon), Osaka University Graduate School of Medicine, Suita, Japan; Department of Public Health and Hygiene, Yamagata University Graduate School of Medical Science, Yamagata, Japan; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
出版信息
Diabetes Res Clin Pract. 2018 Oct;144:111-117. doi: 10.1016/j.diabres.2018.08.012. Epub 2018 Aug 22.
AIM
Diabetic retinopathy (DR) screening is one of the keys in successful diabetes care, but the participation in DR screening is sub-optimal. This study aims to assess the factors associated with participation in a DR screening program in a rural district of Bangladesh.
METHOD
213 persons with diabetes identified in a population-based assessment of over 3000 persons ≥ 40 years were offered free of cost screening for DR. Awareness, attitudes and practice about diabetes and common eye diseases along with socio-demographic factors were assessed.
RESULTS
68 (32%) patients participated in the screening program. After multivariate adjustment, awareness related to diabetes causes eye disease (odds ratio (OR) 8.47, 95% confidence interval (CI) 3.95-18.18), awareness of DR (OR 5.15, 95% CI 1.89-14.01) and awareness of the possibility to prevent DR-related vision loss (OR 3.15, 95% CI 1.53-6.51) were associated with higher proportion of participation. Lack of confidence upon skills of ophthalmic assistants and fear of complications were barriers but socio-economic condition was not a barrier in attending the screening program.
CONCLUSIONS
The major factor associated with participation in DR screening is diabetes-related health literacy in rural Bangladesh. Public health promotion program should be designed to provide health education to increase participation in the screening program.
目的
糖尿病视网膜病变（DR）筛查是成功进行糖尿病护理的关键之一，但 DR 筛查的参与度并不理想。本研究旨在评估孟加拉国农村地区参与 DR 筛查计划的相关因素。
方法
在一项针对 3000 多名年龄≥40 岁人群的基于人群的评估中，发现了 213 名糖尿病患者，为他们提供了免费的 DR 筛查。评估了与糖尿病和常见眼病相关的意识、态度和实践以及社会人口因素。
结果
68 名（32%）患者参加了筛查计划。经过多变量调整后，与糖尿病导致眼病相关的意识（比值比（OR）8.47，95%置信区间（CI）3.95-18.18）、DR 意识（OR 5.15，95% CI 1.89-14.01）和预防 DR 相关视力丧失的可能性意识（OR 3.15，95% CI 1.53-6.51）与更高的参与率相关。对眼科助手技能缺乏信心和对并发症的恐惧是障碍，但社会经济状况并不是参加筛查计划的障碍。
结论
与参与 DR 筛查相关的主要因素是孟加拉国农村地区的糖尿病相关健康素养。应设计公共卫生促进计划，提供健康教育，以提高对筛查计划的参与度。
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