Determinants of diabetic retinopathy in jimma university medical center, south west Ethiopia

Abstract

Background: Diabetic retinopathy (DR) is a vascular disease of the retina which affects patients with diabetes mellitus. Since Diabetic Mellitus patients are suffering from different complications like Diabetic retinopathy and in many developing countries little attention was given to identify the determinant factors that contributed for the occurrences of diabetic retinopathy. Objective: To identify determinants of Diabetic Retinopathy in Jimma University Medical Center Methods: A case-control study was conducted from March 10-May 09, 2018. Diabetic patients who developed and diagnosed as retinopathy were the cases and diabetic patients free of retinopathy were controls. Cases were those with diabetic retinopathy and controls were those free of diabetic retinopathy confirmed by physicians and for data collection, record review and interviewer administered questionnaire was used. Then systematic random sampling was used to select sample of 311(106 cases and 205 controls). Data was coded and entered in to Epi-data version 4.1 and then exported to SPSS 20 for analysis and data was presented with tables. Variables with P-values< 0.25 in binary logistic regression was selected as a candidate for multiple logistic regressions to determine independent determinants of diabetic retinopathy. Odds ratio was calculated with 95 % CI to show strength of association and P-value < 0.05 was used to declare statistical significance. Result: A total of 311(106 cases and 205 controls) DM patients who follow at Jimma University medical center were interviewed with response rate of 97.79%.After multiple logistic regression analysis, being ≥60years of age (AOR=5.04,[95%CI: 1.83,13.87]),being illiterate(AOR=7.17[95% CI:2.61,19.7]), Poor adherence to medication (AOR =3.00[95% CI: 1.29,6.95]), high Systolic Blood Pressure (AOR=3.38[95% CI :1.26,9.05]), having family history of Diabetes Mellitus (AOR=3.95[ 95%CI: 1.64,9.54]), having other micro vascular complications (AOR=3.76[95% CI: 1.33,10.66]), poor glycemic control (AOR=9.08[95%CI: 3.7,22.29]), poor cholesterol control (AOR= 0.21[95%CI: 0.08, 0.51]) and being anaemic (AOR= 2.8[95%CI: 1.05, 7.47]) were the independent predictors of diabetic retinopathy. Conclusion and recommendation: from study participants; older age ≥ 60 years, those of no formal education patients, Poor adherence to medication, high Systolic Blood Pressure, having family history of Diabetes Mellitus, having other micro vascular complication, poor glycemic control, poor cholesterol control and being anaemic patient were the independent predictors of diabetic retinopathy. Jimma University medical center and concerned body should give more attention to older age, take care for illiterate patients to make well informed, work on those of poorly adhered to anti-diabetic patients, inform patients with high systolic blood pressure to follow their blood pressure regularly. Patients withfamily history of Diabetes Mellitusand who have other micro vascular complication should be well handled and treated fairly without any negligence. Finally, blood sugar control, blood serum cholesterol control is mandatory and prevention of anaemia is best option.