Incidence of Diabetic Retinopathy and Predictors among Adult Patients with Diabetes in Central and Southern Ethiopia: A Multicentre follow-up Study

Tagese Yakob ^1* Begidu Yakob ² Awoke Abraham ² Mesfin Manza ³

• ¹ College of Health Sciences and Medicine, Wolaita Sodo University, Sodo, Ethiopia
• ² Division of Nutrition, Maternal and Child Health Unit, Wolaita Zone Health Department, Wolaita Sodo, Ethiopia
• ³ Department of Biostatic and Epidemiology, School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia

Background: Diabetic retinopathy (DR) is becoming a more widespread public concern worldwide, leading to visual impairments. It has become the leading cause of blindness among working-age adults globally, despite established treatments that can reduce the risk by 60%. Objective: This study aimed to determine the incidence of diabetic retinopathy and its predictors among adult patients with diabetes in public hospitals in Central and Southern Ethiopia.Methods: A hospital-based follow-up study was conducted in selected public hospitals in Central and Southern Ethiopia. A total of 376 participants of newly diagnosed adult diabetes were enrolled from2015-2023 and the follow-up the date was from date of enrolment to the development of events. The data were collected by reviewing their records and entered in Epi-data version 4.6.0.2 and exported to STATA version 14 for analysis. Descriptive statistics of the variables were obtained. The Cox proportional hazard assumption was checked. The Cox regression model was used to determine the median time to develop diabetic retinopathy and identify predictors of diabetic retinopathy. Bivariable analysis and multivariable analysis was done, variables with a p-value less than 0.05 and a corresponding 95% confidence interval in the final model were used. Model of adequacy was checked.Results: A total of 376 adult diabetic patient records were reviewed with the mean baseline age (± standard deviation) of 34.8±10 years. Of the total study participants, half of 189 (50.3%) were females. A total of 376 adult patients with diabetes were followed for 682.894 person-years. Overall, an incidence rate of 14.06/100 person-years. Positive proteinuria (AHR = 2.19: 95% CI: 1.18, 4.08), hypertension (AHR = 2.23: 95% CI: 1.39, 3.55), and type II DM (AHR = 2.89: 95% CI: 1.19, 7.05) were identified as significant predictors of diabetic retinopathy.Conclusion: Overall incidence rate of diabetic retinopathy (type 1 and type 2) was high. Diabetic patients with hypertension, proteinuria, and type of diabetes were independent predictors of diabetic retinopathy. The best strategy to protect our eyesight from diabetic retinopathy is to keep our diabetes under control and provide high-risk individuals with diabetes.