Uptake of diabetic retinopathy screening at a secondary level facility in Malawi.
Uptake of diabetic retinopathy screening at a secondary level facility in Malawi.
复制标题
在马拉维的二级设施中摄取糖尿病性视网膜病变筛查。
DOI：
10.1371/journal.pgph.0002567
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
中科院分区：
文献类型：
--
作者：
糖尿病视网膜病变（DR）是长期糖尿病（DM）常见的微血管并发症。DR筛查是一种具有成本效益的预防DR致盲的干预措施。我们进行了一项横断面研究，以调查马拉维南部一家二级糖尿病诊所的机会性DR筛查计划中每年DR筛查的接受情况和预测因素。使用结构化问卷对连续患者进行访谈，记录他们的人口统计学特征、医疗细节和数据：就诊频率、对DR筛查服务的了解程度以及过去一年内DR筛查的转诊史。使用单变量二元逻辑回归来调查前一年DR筛查摄取的预测因素。p值< 0.1的解释变量被纳入多元逻辑回归模型。所有p值<0.05的变量被认为具有统计学意义。我们在三个月内招募了230名参与者，中位年龄为52.5岁（IQR 18-84），中位糖尿病持续时间为4年（IQR 1-7）。平均就诊间隔为1.2个月（SD±0.43），只有59.1% （n = 139）的参与者知道该机构有糖尿病视网膜病变筛查服务。一年多的DR筛查率为20% （n = 46）。单变量分析的最强预测因子是对DR筛查服务存在的认识（OR 10.05, P <0.001）和被转诊进行DR筛查的历史（OR 9.02, P <0.001），这些在多变量分析中仍然显著。改善DR筛查的干预措施应促进患者转诊进行DR筛查，并加强对DR筛查服务的需求和可用性的认识。
Diabetic retinopathy (DR) is a common microvascular complication of long-standing diabetes mellitus (DM). DR screening is a cost-effective intervention for preventing blindness from DR. We conducted a cross-sectional study to investigate the uptake and the predictors of uptake of annual DR screening in an opportunistic DR screening programme at a secondary-level diabetes clinic in Southern Malawi. Consecutive patients were interviewed using a structured questionnaire to record their demographic characteristics, medical details and data regarding; the frequency of clinic visits, knowledge of existence of DR screening services and a history of referral for DR screening in the prior one year. Univariate binary logistic regression was used to investigate predictors of DR screening uptake over the prior one year. Explanatory variables that had a P-value of < 0.1 were included into a multivariate logistic regression model. All variables that had a p-value of <0.05 were considered to be statistically significant. We recruited 230 participants over three months with a median age of 52.5 years (IQR 18–84) and a median duration of diabetes of 4 years (IQR 1–7). The average interval of clinic visits was 1.2 months (SD ± 0.43) and only 59.1% (n = 139) of the participants were aware of the existence of diabetic retinopathy screening services at the facility. The uptake for DR screening over one year was 20% (n = 46). The strongest predictors of uptake on univariate analysis were awareness of the existence of DR screening services (OR 10.05, P <0.001) and a history of being referred for DR screening (OR 9.02, P <0.001) and these remained significant on multivariable analysis. Interventions to improve uptake for DR screening should promote referral of patients for DR screening and strengthen knowledge about the need and availability of DR screening services.