Prevalence and Correlates of Diabetic Retinopathy in a Population-based Survey of Older People in Nakuru, Kenya
Abstract
Purpose To estimate the prevalence of and factors associated with diabetic retinopathy (DR) among people aged ≥ 50 years in Nakuru, Kenya. Methods Probability-proportional-to-size sampling was used to select 100 clusters of 50 people aged ≥ 50 years during 2007-2008. Households within clusters were selected through compact segment sampling. Participants underwent dilated slit lamp biomicroscopy (SLB) by an ophthalmologist and digital retinal photography. Images were graded for DR at the Moorfields Eye Hospital Reading Centre, UK. Diagnosis of DR was based on retinal images where available, otherwise on SLB. Anthropometric measures, including random glucose, and lifestyle factors were measured. Results We examined 4414 adults (response rate 88.1%), of whom 287 had diabetes. A total of 277 of these were screened for DR by SLB, and 195 also underwent retinal photography. The prevalence of any DR diagnosed by retinal images among diabetics was 35.9% (95% confidence interval, CI, 29.7-42.6%). The most common grade of DR was mild/moderate non-proliferative DR (NPDR; 22.1%, 95% CI 16.1-29.4%), while severe NPDR and proliferative DR were less frequent (13.9%, 95% CI 10.0-18.8%). SLB significantly underdiagnosed DR compared to retinal photography, particularly for milder grades. Of 87 individuals with DR, 23 had visual impairment (visual acuity Conclusion DR remains a threat to sight in people with diabetes in this elderly Kenyan population. Screening diabetics may enable those requir…
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The 8% prevalence of referable DR mirrors the real-world scenario within the Lifeline Express Program, while the 4% prevalence was chosen based on data from high-income countries and the 12% prevalence was based on data from other LMICs.
“The 8% prevalence mirrors the real-world scenario within the Lifeline Express Program, while the lower prevalence of 4% was chosen based on data from high-income countries55,56, and the higher prevalence of 12% was based on data from other LMICs57–59.”
From Economic evaluation for medical artificial intelligence: accuracy vs. cost-effectiveness in a diabetic retinopathy screening case (2024) · cites this paper as [59]
The study simulated prevalences of referable DR of 4%, 8%, and 12% to reflect global variations.
“To accommodate different DR screening settings, we simulated at WTP levels ranging from US$ 0 to 30,828, and different prevalences of referable DR (4%, 8%, and 12%) to reflect the global variations.”
From Economic evaluation for medical artificial intelligence: accuracy vs. cost-effectiveness in a diabetic retinopathy screening case (2024) · cites this paper as [59]
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- Authors
- Mathenge, W., Bastawrous, A., Peto, T., Leung, I., Yorston, D., Foster, A., & Kuper, H.
- Affiliations
- Fred Hollows Foundation (AU)
- London School of Hygiene & Tropical Medicine (GB)
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology LondonUK
- Moorfields Eye Hospital NHS Foundation Trust (GB)
- Gartnavel General Hospital (GB)
- Corresponding author
- Kuper, Hannah
- Venue
- Ophthalmic Epidemiology
- Publisher
- Informa UK Limited
- Published
- 2014-04-23
- Volume
- 21
- Issue
- 3
- Pages
- 169-177
- ISSN
- 0928-6586 (ISSN-L)
- 1744-5086
- OpenAlex
- W2130862024
- Cited by
- 51
- References
- 24
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 5 · 2023: 6 · 2022: 7 · 2021: 4 · 2020: 5 · 2019: 4 · 2018: 4 · 2017: 3 · 2016: 2 · 2015: 5
- FWCI
- 3.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Ophthalmic Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (Queen's University Belfast) (submittedVersion)
- Topics
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
- Health Sciences › Medicine › Epidemiology › Ophthalmology and Visual Impairment Studies
- Keywords
- diabetic retinopathy, prevalence, older adults, non-proliferative diabetic retinopathy, proliferative diabetic retinopathy, fundus photography, slit lamp examination, visual impairment, diabetes management, medication adherence, diabetes screening, Nakuru
- MeSH terms
- Aged, Aged, 80 and over, Anthropometry, Blood Glucose, Diabetes Mellitus, Diabetic Retinopathy, Female, Health Surveys, Humans, Kenya, Life Style, Male, Middle Aged, Risk Factors, Visual Acuity, Prevalence, Cluster Analysis, Age Distribution, Sex Distribution
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