SCREENING FOR DIABETIC RETINOPATHY: A COMPARATIVE STUDY BETWEEN HOSPITAL AND COMMUNITY BASED SCREENING AND BETWEEN PAYING AND NON-PAYING PATIENTS
AbstractBackground: Prevalence of diabetes and diabetic retinopathy varies in the population consideringthe background and financial status. Methods: A total of 79,194 people more than 40 years, werescreened for diabetes both in the community and eye hospital setting. Initial screening was carriedout by urine dipstick followed by random blood sugar examination. A value ³ 140 mg/dl of bloodsugar was considered positive for diabetes. All the diabetics were then examined for any evidenceof diabetic retinopathy through indirect ophthalmoscopy in a dilated pupil by a midlevelophthalmologist. Health education campaign at public, patient and professional level was alsoconducted. Results: The results of screening were analyzed for three distinct groups; ruralpopulation, hospital based free patients and hospital based paying patients. The prevalence ofdiabetes was found to be 9.12%, 10.34% and 18.57% in rural community, poor hospital andaffluent hospital groups respectively. The prevalence of diabetic retinopathy in the total screenedpopulation in these three subgroups was 1.92%, 2.52% and 4.42% respectively, while thisprevalence in the diabetic population was 21.05%, 24.39% and 23.80% respectively. The cost perperson screened was $2.6-3.4, while the cost per diabetic identified was $26-28 and the cost perpatient of diabetic retinopathy identified was $ 108-135. Conclusion; The prevalence of diabeticretinopathy was two times more in the affluent hospital patients as compared to poor hospitalpatients or rural population. For each known diabetic, there were four previously undiscovereddiabetics in the rural population, and two previously undiscovered diabetics in hospital basedpopulation.Key words: Diabetes Mellitus, Diabetic Retinopathy, Health Education.
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