Characteristics of patients with diabetic retinopathy in Gaborone, Botswana

Background: Diabetic retinopathy is a cause of preventable blindness globally and is an increasing public health problem in the developing countries. The Botswana National Screening Programme for diabetic retinopathy was launched in October 2009. We report the descriptive epidemiology of diabetic retinopathy in Botswana.
Methods: The study population comprised patients on the National Diabetic Retinopathy Screening register at Princess Marina Hospital, Gaborone. Prevalence of diabetic retinopathy, maculopathy and visual impairment were estimated. Associations of diabetic retinopathy and explanatory variables were explored using logistic regression.
Results: Of the 1,307 patients screened for diabetic retinopathy between October 2009 and August 2011, 67.9% were female and mean age (standard deviation) was 55.0 (14.1) years. The prevalence of DR and maculopathy was 17.7% (95% CI=15.6–19.9) and 14.7% (95% CI=12.7–16.7), respectively. The prevalence of low vision (presenting visual acuity [VA] ≥3/60 but <6/18 in the better eye) and blindness (presenting VA of <3/60 in the better eye) was 15.0% (95% CI=13.3–18.9) and 1.5% (95% CI=0.83–2.9), respectively. Increasing odds of DR were associated with increasing age (Ptrend=0.004), low vision (odds ratio [OR] =2.2; 95% CI=1.6–3.0), blindness (OR=4.6; 95%CI=2.6–8.1) and maculopathy (OR=15.2; 95% CI=10.9–21.3).
Conclusion: Diabetic retinopathy is a common complication of diabetes amongst Batswana patients. Our findings are consistent with prevalence rates in other developing countries and underscore the importance of screening for diabetic retinopathy in developing nations.

Keywords
Diabetic retinopathy; visual impairment; epidemiology; screening programme; Botswana