Piyseana Mapa Mudiyanselage Prabhath Nishantha, Murthy Gudlavalleti Venkata S
National Eye Hospital, Deans Road, Colombo 10 -, Sri Lanka.
Professor of Public Health for Eye Care and Disability, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
Indian J Ophthalmol. 2020 May;68(5):841-846. doi: 10.4103/ijo.IJO_1754_18.
Blindness and visual impairment due to diabetic retinopathy (DR) are avoidable by early screening and timely treatment. The western province of Sri Lanka has the highest prevalence of diabetes mellitus (18.6%) in the country. DR had been given less attention in services expansion because of lack of evidence. The aim of this study was to assess the availability of human resources (HR) and infrastructure for DR in eye care facilities.
A cross-sectional survey was conducted in 51 health care institutions by administering a validated questionnaire schedule and through semi-structured interviews. The data on infrastructure, HR and level of training, and skills were collected during the site visits by observation, frequency counting, and interviewing. Key findings of the interviews were recorded using categorical responses. Data analysis was done using MS-Excel and STATA/IC-Version 2-13.0 packages.
The response rate of the survey was 84.3% (43/51). There were 40 board-certified ophthalmologists and 6 vitreo-retinal surgeons in the region, of whom 77.5% (31/40) were in Colombo district. The highest population-adjusted DR-related infrastructure ratios were recorded from Colombo district. Mid-level cadres such as medical officers' mean skill score of DR screening and treatment was low (0.37, 95% CI 0.32-0.40).
There is no systematic DR screening program, and HR and infrastructure distribution was not aligned to the population need in the western province. Urgent attention should be paid to expand the service delivery and mid-level HR training for DR screening and treatment in this region.
糖尿病视网膜病变（DR）导致的失明和视力损害可通过早期筛查和及时治疗避免。斯里兰卡西部省份是该国糖尿病患病率最高的地区（18.6%）。由于缺乏证据，在服务扩展过程中DR受到的关注较少。本研究的目的是评估眼科护理机构中用于DR的人力资源（HR）和基础设施情况。
通过发放经过验证的问卷调查表并进行半结构化访谈，在51家医疗机构开展横断面调查。在实地考察期间，通过观察、频次计数和访谈收集有关基础设施、HR、培训水平和技能的数据。访谈的主要结果采用分类回答记录。使用MS-Excel和STATA/IC-版本2-13.0软件包进行数据分析。
调查的回复率为84.3%（43/51）。该地区有40名获得委员会认证的眼科医生和6名玻璃体视网膜外科医生，其中77.5%（31/40）在科伦坡地区。科伦坡地区记录的与DR相关的基础设施比例在人口调整后最高。中级干部如医务人员的DR筛查和治疗平均技能得分较低（0.37，95%CI 0.32 - 0.40）。
西部省份没有系统的DR筛查项目，HR和基础设施的分布与人口需求不一致。应紧急关注扩大该地区DR筛查和治疗的服务提供以及中级HR培训。
