Sight-threatening diabetic retinopathy and its predictors among patients with diabetes visiting Adare General Hospital in Southern Ethiopia: a hospital-based cross-sectional study

OBJECTIVE

The study aimed to determine the prevalence of sight-threatening diabetic retinopathy and its predictors among patients with diabetes attending Adare General Hospital in Southern Ethiopia.

DESIGN

A hospital-based cross-sectional study was conducted using a systematic random sampling method.

SETTING

The study was conducted at the diabetic clinic of Adare General Hospital in Sidama region, Southern Ethiopia.

PARTICIPANTS

The study included 391 patients with diabetes aged ≥18 years who had attended the diabetic clinic of Adare General Hospital in Southern Ethiopia.

MAIN OUTCOME MEASURES

Data were collected using questionnaires completed by an interviewer, a review of medical records and eye examinations.

RESULT

The study included 391 patients with diabetes with a median age of 49 years. The prevalence of sight-threatening diabetic retinopathy was 10.7% (95% CI: 7.7% to 14%). Rural dwellers (adjusted OR (AOR)=2.17, 95% CI: 1.05 to 4.46), duration of diabetes ≥6 years (AOR=2.43, 95% CI: 1.06 to 5.57), poor glycaemic control (AOR=2.80, 95% CI: 1.03 to 7.64), low physical activity (AOR=2.85, 95% CI: 1.01 to 8.05), hypertension (AOR=3.25, 95% CI: 1.48 to 7.15) and diabetic peripheral neuropathy (AOR=3.32, 95% CI: 1.18 to 9.33) were significantly associated with sight-threatening diabetic retinopathy.

CONCLUSION

This study showed a high prevalence of sight-threatening diabetic retinopathy. Sight-threatening diabetic retinopathy was significantly associated with modified factors such as glycaemic control, hypertension, physical activity and diabetic peripheral neuropathy. Therefore, all patients with diabetes were recommended to maintain normal blood glucose, avoid hypertension, exercise regularly and have regular eye examinations.

Symptomatic Dry Eye Disease and Associated Factors Among Adult Diabetic Patients in Adare General Hospital, Hawassa City, Southern Ethiopia, 2023

Introduction

Symptomatic dry eye disease is a multifactorial ocular surface condition caused by disruption of the precorneal tear film and is a common clinical finding in diabetic patients. However, there was no study on the prevalence and associated factors of symptomatic dry eye disease among diabetic patients in Ethiopia or in the study area.

Purpose

This study aimed to investigate the prevalence and associated factors of symptomatic dry eye disease among adult diabetic patients in Adare General Hospital, Hawassa City, Southern Ethiopia, in 2023.

Methods

A hospital-based cross-sectional study design was conducted on 493 adult diabetic patients who were selected using systematic random sampling, from April 23 to June 8, 2023. Data were collected through a face-to-face interview using an ocular surface disease index questionnaire. Binary logistic regression was performed to identify factors potentially associated with symptomatic dry eye disease. Variable with a P value of <0.05 was considered statistically significant.

Results

A total of 488 subjects participated in this study with a response rate of 99%. The prevalence of symptomatic dry eye disease was 34.8% (95% CI = 30.6-39.1). College and university educational status (AOR = 5.88, 95% CI = 2.25-15.38), government employed (AOR = 2.22, 95% CI = 1.05-4.68), use of visual display unit >5 hours (AOR = 4.41, 95% CI = 1.51-12.87), duration of diabetes ≥11 years (AOR = 3.57, 95% CI = 1.28-9.90), poor glycemic control (AOR = 2.13, 95% CI = 1.21-3.75), allergic conjunctivitis (AOR = 1.99, 95% CI = 1.12-3.54), and debris in the tear film (AOR = 3.63, 95% CI = 1.53-8.61) were positively associated with symptomatic dry eye disease.

Conclusion

The study revealed a high prevalence of symptomatic dry eye disease. Higher educational status, government employed, use of visual display unit, longer duration of diabetes, poor glycemic control, allergic conjunctivitis, and tear film debris were significantly associated with symptomatic dry eye disease. Breaks in screen use, good glycemic control, and treatment of ocular morbidities such as allergic conjunctivitis and debris in the tear film were recommended for all diabetic patients.

Ocular Protection Practice and Associated Factors Among Ethiopian Welders: Institution-Based Cross-Sectional Study

Introduction

Work-related ocular injury is a global public health problem, particularly among welders and is reduced through proper ocular protection practice. No previous studies have explored ocular protection practice and associated factors among welders in Ethiopia or in the study area.

Objective

This study aimed to assess the proportion of ocular protection practice and associated factors among welders in Gondar city, Northwest Ethiopia.

Methods

An institution-based cross-sectional study was conducted among 403 welders in Gondar city, selected using systematic random sampling with an interval of 2, from July 6 to 23, 2021. Data were collected using a pre-tested structured questionnaire and an observational checklist. Binary logistic regression was used to identify factors associated with ocular protection practice and association was expressed using an adjusted odds ratio with a 95% confidence interval (CI). Variables with a P-value of less than 0.05 were considered statistically significant.

Results

Of 396 participated welders, 81.8% worked without job training, and 33.1% had faced ocular injury. Nearly 86% of welders had access to personal protective eyewear but their knowledge and attitude towards personal protective eyewear were 48.2% (95% CI: 44.8, 51.4) and 61.4% (95% CI: 57.6, 64.7), respectively. The proportion of a good-level of ocular protection practice was 56.8% (95% CI: 52.8, 61.9). Being gas welder (adjusted odds ratio [AOR]=0.26, 95% CI: 0.12, 0.53), work experience (AOR = 1.10, 95% CI: 1.01, 1.21), job training (AOR = 4.90, 95% CI: 2.32, 10.35), welders rated the cost of personal protective eyewear as fair (AOR = 2.30, 95% CI: 1.26, 4.20) and history ocular injury (AOR = 4.20, 95% CI: 2.40, 6.97) were positively associated with a good-level proportion of ocular protection practice.

Conclusion

This study found that the proportion of a good-level of ocular protection practice of welders was fair. Being gas welder, job training, work experience, history of ocular injury and welders rated the cost of personal protective eyewear as fair were significantly associated with a good-level of ocular protection practice.

Prevalence, causes and associated factors of visual impairment and blindness among older population in outreach site, Northwest Ethiopia. A dual center cross-sectional study

Purpose

The study aimed to determine the prevalence, causes, and associated factors of visual impairment and blindness among the older population in Outreach sites, Northwest Ethiopia.

Methods

A community-outreach-based cross-sectional study was conducted on 821 older population which were selected using a systematic random sampling technique. Face-to-face interviews and ocular examinations were performed to collect the data. A binary logistic regression was performed.

Result

A total of 821 participants were recruited for the study with a median age of 57 years, with a range of 40-91 years. Out of 821 participants, 41.8% had visual impairment, and 11.7% were blind. Sixty-four and fifty seven percent of visual impairment and blindness were caused by cataract. Age ≥70years (AOR=15.0; 95%CI: 8.4-26.9), rural residency (AOR=2.3; 95%CI: 1.5-3.6), non-formal education (AOR=3.0; 95%CI: 1.6-5.6), unemployed (AOR=1.5;95%CI:1.05-2.4) and history of eye examination (AOR=1.7;95%CI:1.1-2.8) were positively associated with visual impairment. Similarly, blindness was significantly associated with age ≥ 70years (AOR=7.2; 95%CI: 3.1-16.6), rural residency (AOR=2.2;95%CI:1.2-4.2), and history of eye examination (AOR=1.9; 95%CI: 1.1- 3.3).

Conclusion

the prevalence of visual impairment and blindness in this study was found to be high. Age, residency, educational status, occupational status, and history of eye examination were significantly associated with visual impairment and blindness.

Eye Care Utilization among Older Subjects with Visual Impairment in Northwest Ethiopia

Purpose

To find out the level of eye care service utilization and its determinants among the elderly visually impaired populations while visiting ophthalmic outreach locations in North-Western Ethiopia, 2021.

Methods

An ophthalmic outreach-based cross-sectional study was conducted on 852 visually impaired older people. Participants were selected by using a systematic random sampling method from January to July 2021. Data were collected by using an interviewer-administered questionnaire and an ocular examination. The collected data were entered into the Epi Info 7, and analyzed using SPSS 20. A binary logistic regression was fitted.

Results

A total of 821 participants, with a response rate of 96.5%, were included in the study. The utilization of eye care services within the past two years prior to the study was 21.1% (95 % CI: 18.2-23.9). Having systemic disease (AOR = 3.2, 95% CI: 1.5-7.0), being a spectacle wearer (AOR = 4.5, 95% CI: 2.0-9.4), having visual impairment at distance (AOR = 2.9; 95% CI: 1.5-5.6), being blind (AOR = 2.9; 95% CI: 1.5-5.6), duration of visual impairment ≤ 1 year (AOR = 2.5; 95% CI: 1.3-4.9) were all significantly associated.

Conclusion

In this study, utilization of eye care services was low. Being visually impaired at distance, being blind, recent onset of visual impairment, being a spectacle wearer, and having systemic disease were all related to the use of eye care services. The commonest barriers to utilization of eye care services were financial scarcity and long distances between eye care facilities.

Prevalence and associated factors of visual impairment among adult diabetic patients visiting Adare General Hospital, Hawassa, South Ethiopia, 2022

BACKGROUND

The increased prevalence of visual impairment among diabetic patients has become a major public health problem. However, there was limited information on the extent of visual impairment among diabetic patients in our country, and there was no study in the study area. Providing updated data regarding this area is critical for the prevention of visual impairment among diabetic patients.

PURPOSE

The study aimed to assess the prevalence and associated factors of visual impairment among adult diabetic patients visiting Adare General Hospital, Hawassa, South Ethiopia, 2022.

METHODS

A hospital-based cross-sectional study was conducted on adult diabetic patients from May 30 to July 15, 2022, at Adare General Hospital, Hawassa, South Ethiopia. A systematic random sampling method was used to select 398 study participants. Data was collected through a face-to-face interview, a medical chart review, and an ocular examination. A binary logistic regression was performed to identify potential risk factors for visual impairment and their strength of association was expressed using an adjusted odds ratio with a 95% confidence interval. Variables with a P-value of < 0.05 were considered statistically significant.

RESULT

In this study, a total of 391 participants were involved, with a response rate of 98.2%. The prevalence of visual impairment was 28.6% (95% CI: 24.6-33.0). Age ≥ 60 years (AOR = 4.03, 95% CI: 1.72, 10.71), poor physical exercise (AOR = 3.26, 95% CI: 1.62, 6.53), poor glycemic control (AOR = 4.34, 95% CI: 2.26, 8.34), history of eye examination (AOR = 2.94, 95% CI: 1.50, 5.76), duration of diabetes ≥ 9 years (AOR = 4.78, 95% CI: 2.11, 10.83) and diabetic peripheral neuropathy (AOR = 3.01, 95% CI: 1.21, 7.50) were positively associated with visual impairment.

CONCLUSION

The study found a high prevalence of visual impairment among adult diabetic patients. Older age, longer duration of diabetes, poor physical exercise, poor glycemic control, history of eye examination, and diabetic peripheral neuropathy were significantly associated with visual impairment. Thus, regular physical activity, good control of glucose levels, and regular eye exams were recommended for all diabetic patients.

Visually significant cataract and associated factors among older people attending a community ophthalmic service in central Gondar Zone, Northwest Ethiopia: a cross-sectional study

Objective

In this study, we aimed to determine the prevalence of visually significant cataract and associated factors among older people attending community ophthalmic services in the central Gondar Zone, Northwest Ethiopia.

Methods

We conducted a community outreach-based cross-sectional study among adults aged ≥40 years in the central Gondar Zone from 30 May to 15 June 2021. We used systematic random sampling to select study participants. Interviewer-administered questionnaires and ocular examinations were performed and the data recorded. We applied binary logistic regression to identify factors associated with visually significant cataract.

Results

A total of 821 participants were included, with median age 57 years. The prevalence of visually significant cataract was 29.1% (95% CI: 26.1–32.0). Age ≥80 years (adjusted odds ratio [AOR] = 16.9; 95% CI: 7.5–38.4), rural residence (AOR = 1.7; 95% CI: 1.02–2.7), unmarried status (AOR = 1.9; 95% CI: 1.2–3.2), illiteracy (AOR = 2.9; 95% CI: 1.4–6.1), unemployed status (AOR = 1.7; 95% CI: 1.1–2.7), and sunlight exposure ≥5 hours per day (AOR = 1.6; 95% CI: 1.04–2.4) were significantly associated with visually significant cataract.

Conclusion

In this study, visually significant cataract was found to be high, which requires immediate public health intervention.

Attitude and related factors towards strabismus among adults living in Gondar town, Northwest Ethiopia: a community-based cross-sectional study

Cultural belief in Ethiopia showed that strabismus can be caused by exposure to sunlight during infancy, an outrage from God, and looking sideways. In addition, Ethiopians also believe that strabismus can resolve by its self and is a sign of good luck. Due to these reasons many patients with strabismus come to eye care clinics after developing amblyopia. This study aimed to assess the level of attitude and related factors toward strabismus among adults living in Gondar town, Northwest Ethiopia. A community-based cross-sectional study was conducted on a sample size of 634 adults from April 9 to April 23, 2019. Data were collected using a pretested structured questionnaire through face-to-face interviews, and the study participants were chosen by applying a multistage random sampling technique. Data were entered with EPI info version 7 and imported into SPSS version 20 for analysis. Frequency, statistical summary, and cross-tabulations were used for the descriptive analysis of the entered data. Binary logistic regression was fitted, and all independent variables with a P-value of less than 0.2 in the bivariable analysis were entered into a multivariable binary logistic regression. Variables with a P-value of less than or equal to 0.05 were considered statistically significant. Respondents who answered greater than or equal to the median score of attitude-related questions were designated to have a favorable attitude toward strabismus. In this study, 602 adults were participated with a response rate of 94.9% and the median age of the participants was 33 ± 14 years. The overall proportion of favorable attitudes toward strabismus was 71.8%. Having secondary school as an educational status (AOR = 2.8 (95% CI: 1.2, 6.4)) and heard about strabismus (AOR = 7.4 (95%CI: 3.7, 14.9)) were positively whereas being unemployed (AOR = 0.3(95% CI: 0.1, 0.7)) and high monthly income (AOR = 0.5(95%CI: 0.3, 0.9)) were negatively associated with a favorable attitude regarding strabismus. Eighty-five percent (88.5%) of participants agreed that early treatment of strabismus had a better outcome. Besides, 57.6% of participants have agreed that untreated strabismus can cause amblyopia. About three fourth of the study participants had a favorable attitude toward strabismus. Educational status, heard about strabismus, occupation, and monthly income were significantly associated with a favorable attitude toward strabismus. Most of the study participants agreed that untreated strabismus can cause poor cosmoses. Fear of surgery and high cost were reported by study participants as the main barriers to seeking treatment of strabismus.

Knowledge and Attitude of Refractive Error Among Public High School Students in Gondar City

INTRODUCTION

Refractive error (RE) is the main cause of visual impairment and blindness in the world. Lack of knowledge and unfavorable attitude of refractive error can have long-term consequences and dramatic effects in children and adults, such as loss of educational and employment opportunities, loss of economic gain for individuals, families, and societies, and impaired quality of life.

AIM

The aim of this study was to assess the level of knowledge and attitude of refractive error among public high school students in Gondar city, Northwest Ethiopia.

METHODS

A school-based cross-sectional study was conducted on 390 public high school students. Those participants were selected by applying a systematic random sampling technique with an interval of 4. Data were collected using a pre-tested structured questionnaire through face-to-face interviews. The collected data were entered into Epi Info version 7.0 and exported into SPSS version 20 for analysis. Results were described using tables and text.

RESULTS

A total of 390 study participants were included in this study with a 92.4% response rate. The overall proportion of good knowledge and a favorable attitude towards a refractive error were 53.8% and 52.1%, respectively. From the study participants, 38.7%, 41.7%, and 64.1% did not know the definition, the risk factors, and the symptoms of refractive error, respectively. Moreover, about 31.3% of the participants believed that wearing spectacle could damage their eyes, whereas 44.1% of the participants agreed with the need for spectacle correction for young people with RE.

CONCLUSION

The proportion of good knowledge and a favorable attitude towards refractive error among public high school students were fair. We recommended that eye care practitioners be committed to increasing the knowledge and attitude of students towards refractive error through eye health education to reduce visual impairment due to refractive error.

Use of Eye Care Service and Associated Factors Among Adult Diabetic Patients Attending at Diabetic Clinics in Two Referral Hospitals, Northeast Ethiopia

PURPOSE

The objective of this study was to determine the proportion of use of eye care service and associated factors among adult diabetic patients attending diabetic clinics in two referral hospitals, Northeast Ethiopia, 2020.

METHODS

A hospital-based cross-sectional study was carried out with a sample size of 546 at Dessie and Debre-Birhan Comprehensive Specialized Hospitals from July 06 to August 14/2020. Systematic random sampling with a sampling fraction of 2 was employed to select study participants at outpatient departments in diabetic clinics. A pre-tested structured questionnaire, checklist, and visual acuity chart were used to collect the data. The collected data were entered into EPI-data version 4.4 and analyzed using Statistical Package for Social Sciences (SPSS) version 25. Binary logistic regression was fitted to identify the possible factors associated with the outcome variable, and the strength of association was expressed using an adjusted odds ratio at a 95% confidence interval. Variables with p-values of less than 0.05 were considered statistically significant.

RESULTS

A total of 531 adult patients with diabetes participated with a response rate of 97.3%. In this study, the proportion of use of eye care service within the past 1 year was 31.5% (95% CI: 27.5, 35.4). Age from 40 to 64 years (AOR=2.86, 95% CI; 1.43,5.70) and >65 years (AOR=3.15, 95% CI: 1.32,7.50), duration of diabetes 6-10 years (AOR=2.15, 95% CI: 1.26, 3.69) and >11 years (AOR=2.93, 95% CI: 1.51, 5.69), presence of visual symptoms (AOR=3.12, 95% CI: 1.56, 6.18), good attitude on the need of a regular eye checkup (AOR=2.87, 95% CI: 1.68, 4.94), and good knowledge about diabetic ocular complication (AOR=2.29, 95% CI: 1.33, 3.94) were positively associated with the use of eye care service.

CONCLUSION

The proportion of use of eye care service among adult diabetic patients was low. The use of eye care service was significantly and independently associated with older age, longer duration of diabetes, presence of visual symptoms, good attitude on the need of a regular eye checkup, and good knowledge about diabetic ocular complication. We recommend that the patients with diabetes should be taught about diabetic ocular complications and the importance of regular eye check-ups by health professionals to increase utilization of eye care services by patients with diabetes.

Proportion, Causes and Associated Factors of Blindness Among Adult Patients Attending Tertiary Eye Care and Training Center in Ethiopia

PURPOSE

This study aimed to estimate the magnitude of blindness, identify causes and associated factors among adult patients who visited a Tertiary Eye Care Training Center in Gondar, Ethiopia.

METHODS

A hospital-based cross-sectional study was done at University of Gondar Tertiary Eye Care and Training Center. 708 participants (99.02% of invited) were recruited in this study with a systematic random sampling technique. Interviewer administered questioner and physical examination were applied to collect the data. Blindness was defined as the presenting visual acuity less than 3/60 in the better eye according to the World Health Organization criterion for visual acuity. Data was entered with Epi Info 7 and imported into SPSS for coding and analysis. Descriptive and analytical statistics were performed to analyze the entered data. Adjusted odds ratio was used to show the strength of the association and variables with a P-value of < 0.05 were considered as statistically significant.

RESULTS

The proportion of blindness in this study was 14.3% (95% CI: 11.8-16.8). Low monthly income (AOR: 4.9; 95% CI: 1.4, 17.1), aged ≥ 60-69 (AOA: 2.9, 95% CI: 1.2, 7.6), and aged ≥ 70 years (AOR: 4.8; 95% CI: 1.9, 12.2) were positively associated with blindness. In this study, the leading cause of blindness was cataract (49.5%), followed by glaucoma (18.8%) and Age-related macular degeneration (AMD) (9.9%).

CONCLUSION

The proportion of blindness was 14.3%. Cataract, glaucoma and AMD were the common causes of blindness. Low monthly income and older age were significantly increased the risk of blindness.