Screening for diabetic retinopathy at a health centre in South Africa : a cross-sectional study
dc.contributor.author | Zulu, Ntokozo | |
dc.contributor.author | Piotie, Patrick Ngassa | |
dc.contributor.author | Webb, Elizabeth M. | |
dc.contributor.author | Maphenduka, Wezi G. | |
dc.contributor.author | Cook, Steve | |
dc.contributor.author | Rheeder, Paul | |
dc.contributor.email | patrick.ngassapiotie@up.ac.za | |
dc.date.accessioned | 2025-07-10T10:39:55Z | |
dc.date.available | 2025-07-10T10:39:55Z | |
dc.date.issued | 2025-01 | |
dc.description | DATA AVAILABILITY : The data that support the findings of this study are available from the corresponding author, P.N.P., upon reasonable request. | |
dc.description.abstract | BACKGROUND : In South Africa, screening for diabetic retinopathy (DR) is non-existent at the primary healthcare (PHC) level because of the absence of a screening programme. This leads to preventable vision loss. AIM : To describe the clinical characteristics and outcomes of eye screenings and subsequent referrals. SETTING : Laudium Community Health Centre (CHC), a PHC facility in Tshwane. METHODS : We conducted a cross-sectional study from February 2022 to August 2022. Individuals with diabetes were screened for eye complications using visual acuity testing, intraocular pressure measurement, and fundoscopy with a non-mydriatic digital fundus camera. Fundus images were analysed by an optometrist and an artificial intelligence (AI) programme. Demographic and clinical data were collected. RESULTS : A total of 120 participants were included, with the majority (60.7%) from Laudium CHC. Most participants (64.2%) were on oral agents, and 66.7% were women. The mean haemoglobin A1c (HbA1c) was 8.3%, with a median diabetes duration of 8 years. Artificial intelligence detected more glaucoma cases (17.5% vs 9.2%) and DR (23.3% vs 15.8%) compared to the optometrist. In contrast, the optometrist identified more cases of macula pathology (29.2% vs 19.2%). Participants (n = 79) were referred to an ophthalmologist for diagnosis confirmation and management. CONCLUSION : The study revealed that while DR was not highly prevalent among PHC patients with diabetes, there was a significant referral rate for other ocular complications. Artificial intelligence can enhance early detection and improve efficiency. CONTRIBUTION : The findings underscore the need to integrate diabetes eye screening programmes into PHC services for people living with diabetes. | |
dc.description.department | School of Health Systems and Public Health (SHSPH) | |
dc.description.department | Ophthalmology | |
dc.description.department | Internal Medicine | |
dc.description.librarian | hj2025 | |
dc.description.sdg | SDG-03: Good health and well-being | |
dc.description.uri | http://publichealthinafrica.org/ | |
dc.identifier.citation | Zulu, N., Piotie, P.N., Webb, E.M., Maphenduka, W.G., Cook, S. & Rheeder, P. Screening for diabetic retinopathy at a health centre in South Africa: A cross-sectional study. Journal of Public Health in Africa 2025;16(1), a681. https://doi.org/10.4102/jphia.v16i1.681. | |
dc.identifier.issn | 2038-9922 (print) | |
dc.identifier.issn | 2038-9930 (online) | |
dc.identifier.other | 10.4102/jphia.v16i1.681 | |
dc.identifier.uri | http://hdl.handle.net/2263/103287 | |
dc.language.iso | en | |
dc.publisher | AOSIS | |
dc.rights | © 2025. The Authors. Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License. | |
dc.subject | Diabetic retinopathy | |
dc.subject | Screening | |
dc.subject | Primary healthcare (PHC) | |
dc.subject | Diabetes mellitus | |
dc.subject | Non-mydriatic photography | |
dc.subject | Fundus camera | |
dc.subject | Microvascular complications | |
dc.subject | Artificial intelligence (AI) | |
dc.title | Screening for diabetic retinopathy at a health centre in South Africa : a cross-sectional study | |
dc.type | Article |