Rapid assessment of avoidable blindness and diabetic retinopathy in people aged 50 years and older in the National Capital District of Papua New Guinea.


Journal

The British journal of ophthalmology
ISSN: 1468-2079
Titre abrégé: Br J Ophthalmol
Pays: England
ID NLM: 0421041

Informations de publication

Date de publication:
06 2019
Historique:
received: 27 12 2017
revised: 22 05 2018
accepted: 20 06 2018
pubmed: 6 7 2018
medline: 21 12 2019
entrez: 6 7 2018
Statut: ppublish

Résumé

To conduct an assessment of avoidable blindness, diabetes mellitus and diabetic retinopathy (DR) in adults aged 50 years and older in the National Capital District (NCD) region of Papua New Guinea (PNG). A cross-sectional population-based survey was performed for which 25 clusters of 50 people aged ≥50 years were randomly selected from the NCD region. The standardised rapid assessment of avoidable blindness (RAAB) with diabetic retinopathy (+DR) methodology was used. Blindness was defined as presenting visual acuity <3/60 in the better eye. Participants were classified as having diabetes if they were known to have diabetes or if their random blood glucose level was ≥200 mg/dL. Dilated fundus examination and Scottish DR grading were performed. In total, 1192 out of 1250 eligible participants (95.4%) were examined. Of these, 7.8% had known or newly diagnosed diabetes. Seventy-one per cent of participants with known diabetes had a blood glucose level ≥200 mg/dL, and 82.9% had never had an ophthalmological examination for DR. Prevalence of DR and/or maculopathy was 46.4%. The age-adjusted and sex-adjusted prevalence of diabetes was estimated at 8.1% (95% CI 5.7% to 10.4%) in the population aged 50 years or older in the NCD region of PNG. Prevalence of diabetes in adults aged 50 years and older was lower than reported elsewhere in the region, and lower than other RAAB+DR surveys. Despite this, the prevalence of DR is high compared with other RAAB+DR surveys and demonstrates the need for increased awareness and accessibility to eye services for people with diabetes.

Sections du résumé

BACKGROUND/AIMS
To conduct an assessment of avoidable blindness, diabetes mellitus and diabetic retinopathy (DR) in adults aged 50 years and older in the National Capital District (NCD) region of Papua New Guinea (PNG).
METHODS
A cross-sectional population-based survey was performed for which 25 clusters of 50 people aged ≥50 years were randomly selected from the NCD region. The standardised rapid assessment of avoidable blindness (RAAB) with diabetic retinopathy (+DR) methodology was used. Blindness was defined as presenting visual acuity <3/60 in the better eye. Participants were classified as having diabetes if they were known to have diabetes or if their random blood glucose level was ≥200 mg/dL. Dilated fundus examination and Scottish DR grading were performed.
RESULTS
In total, 1192 out of 1250 eligible participants (95.4%) were examined. Of these, 7.8% had known or newly diagnosed diabetes. Seventy-one per cent of participants with known diabetes had a blood glucose level ≥200 mg/dL, and 82.9% had never had an ophthalmological examination for DR. Prevalence of DR and/or maculopathy was 46.4%. The age-adjusted and sex-adjusted prevalence of diabetes was estimated at 8.1% (95% CI 5.7% to 10.4%) in the population aged 50 years or older in the NCD region of PNG.
CONCLUSIONS
Prevalence of diabetes in adults aged 50 years and older was lower than reported elsewhere in the region, and lower than other RAAB+DR surveys. Despite this, the prevalence of DR is high compared with other RAAB+DR surveys and demonstrates the need for increased awareness and accessibility to eye services for people with diabetes.

Identifiants

pubmed: 29973367
pii: bjophthalmol-2017-311803
doi: 10.1136/bjophthalmol-2017-311803
doi:

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

743-747

Informations de copyright

© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Anthea Burnett (A)

Brien Holden Vision Institute, Sydney, New South Wales, Australia a.burnett@brienholdenvision.org.
School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia.

Ling Lee (L)

Brien Holden Vision Institute, Sydney, New South Wales, Australia.
School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia.

Fabrizio D'Esposito (F)

Fred Hollows Foundation, Melbourne, Victoria, Australia.

Geoffrey Wabulembo (G)

CBM, Port Moresby, Papua New Guinea.

Anaseini Cama (A)

Pacific Trachoma Initiative, The Fred Hollows Foundation, Sydney, New South Wales, Australia.

Georgia Guldan (G)

School of Medical and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea.

Marleen Nelisse (M)

Fred Hollows Foundation, Auckland, New Zealand.

Samuel Peter Koim (SP)

PNG Eye Care, Port Moresby, Papua New Guinea.

Drew Keys (D)

Brien Holden Vision Institute, Sydney, New South Wales, Australia.
PNG Eye Care, Port Moresby, Papua New Guinea.
International Agency for the Prevention of Blindness, London, UK.
National Prevention of Blindness Committee, Port Moresby, Papua New Guinea.

Alison J Poffley (AJ)

Brien Holden Vision Institute, Sydney, New South Wales, Australia.

Hans Limburg (H)

Health Information Services, Grootebroek, The Netherlands.

Jambi Garap (J)

PNG Eye Care, Port Moresby, Papua New Guinea.
National Prevention of Blindness Committee, Port Moresby, Papua New Guinea.

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