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Epidemiology of diabetic retinopathy and maculopathy in Africa: a systematic review

Burgess, P. I., MacCormick, I. J. C., Harding, S. P., Bastawrous, A., Beare, N. A. V. and Garner, Paul ORCID: https://orcid.org/0000-0002-0607-6941 (2013) 'Epidemiology of diabetic retinopathy and maculopathy in Africa: a systematic review'. Diabetic Medicine, Vol 30, Issue 4, pp. 399-412.

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Abstract

Aim
To summarize findings from studies reporting the prevalence and incidence of diabetic retinopathy and diabetic maculopathy in African countries in light of the rising prevalence of diabetes mellitus.

Methods
Using a predefined search strategy, we systematically searched MEDLINE, EMBASE, Science Citation index and Conference Proceedings Citation index, African Index Medicus and the grey literature database ‘OpenSIGLE’ for studies published between January 1990 and February 2011. Included studies reported prevalence or incidence of diabetic retinopathy or diabetic maculopathy of subjects with diabetes resident in African countries.

Results
Sixty-two studies from 21 countries were included: three population-based surveys; two cohort studies; five case–control studies; 32 diabetes clinic-based, nine eye clinic-based and 11 other hospital-based surveys. Included studies varied considerably in terms of patient selection, method of assessing the eye and retinopathy classification. In population-based studies, the reported prevalence range in patients with diabetes for diabetic retinopathy was 30.2 to 31.6%, proliferative diabetic retinopathy 0.9 to 1.3%, and any maculopathy 1.2 to 4.5%. In diabetes clinic-based surveys, the reported prevalence range for diabetic retinopathy was 7.0 to 62.4%, proliferative diabetic retinopathy 0 to 6.9%, and any maculopathy 1.2 to 31.1%. No obvious association between prevalence and income level of the country was detected.

Conclusions
Large, community-based cross-sectional and cohort studies are needed to investigate rates and determinants of prevalence of diabetic retinopathy, incidence and progression in Africa. Consensus is needed on the most appropriate methods of identification and classification of retinopathy for research and clinical practice. Estimates of prevalence of diabetic retinopathy, proliferative diabetic retinopathy and maculopathy are comparable with recent European and American studies.

Item Type: Article
Subjects: WA Public Health > Statistics. Surveys > WA 950 Theory or methods of medical statistics. Epidemiologic methods
WK Endocrine System > WK 810 Diabetes mellitus
WK Endocrine System > WK 835 Complications of diabetes
WW Ophthalmology > Eye Structures and their Diseases > WW 270 Retina
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1111/j.1464-5491.2012.03756.x
Depositing User: Lynn Roberts-Maloney
Date Deposited: 12 Nov 2014 11:14
Last Modified: 06 Feb 2018 13:08
URI: https://archive.lstmed.ac.uk/id/eprint/4573

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