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Results of a community-based screening programme for diabetic retinopathy and childhood blindness in district

Noor Bakht Nizamani1, Khalid Iqbal Talpur1, Farooq Awan2

  • 1Department of Ophthalmology, Sindh Institute of Ophthalmology and Visual Sciences, Hyderabad, Sindh, Pakistan.

BMJ Open Ophthalmology
|January 23, 2018
PubMed

Insights

A community screening in Hyderabad, Pakistan, found a 17% prevalence of diabetic retinopathy (DR) among adults with diabetes. Refractive errors were the main cause of childhood visual impairment, successfully managed with early detection.

Area of Science:

  • Public Health
  • Ophthalmology
  • Endocrinology

Background:

  • Community-based screening programs are vital for early detection of non-communicable diseases and their complications.
  • Diabetes and its ocular complications, like diabetic retinopathy, pose a significant public health challenge globally and in developing regions.
  • Childhood blindness necessitates early identification and intervention to prevent long-term visual impairment.

Purpose of the Study:

  • To evaluate the outcomes of a community-based screening initiative for diabetes, diabetic retinopathy (DR), and childhood blindness (CB) in Hyderabad District, Pakistan.
  • To determine the prevalence of DR in diabetic patients within the study area.
  • To identify the primary causes of visual impairment in children and assess the effectiveness of early detection.

Main Methods:

  • A prospective, cross-sectional study was conducted from January 2014 to December 2015, screening for diabetes, DR, and CB.
  • Trained female health workers performed initial screening for high-risk individuals, referring them to basic health units.
  • Medical officers and optometrists provided further assessment, with complex cases referred to the Sindh Institute of Ophthalmology and Visual Sciences for management.

Main Results:

  • The screening covered 995,244 individuals, including 2,622 children for CB and 16,760 adults for diabetes.
  • Among screened adults, 3,075 had elevated random blood glucose levels (>140 mg/dL), with 17% diagnosed with diabetic retinopathy (DR).
  • Refractive error was identified as the leading cause of visual impairment in children (42%).

Conclusions:

  • The screening program identified a substantial prevalence of diabetic retinopathy (17%) among diabetic individuals in Hyderabad District.
  • Refractive errors were the most frequent cause of childhood visual impairment, with timely diagnosis leading to successful management.
  • The community-based screening approach proved beneficial, reaching a large population and facilitating timely medical interventions.
Abstract

Keywords:
child health (paediatrics)epidemiologypublic healthretinavision

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