Thesis (MPH.) -- University of Limpopo, 2021 / Background: Diabetes mellitus (DM) is a major public health problem, and it remains
one of the global epidemics of non-communicable diseases. Diabetic retinopathy (DR)
is a micro-vascular complication of DM due to a prolonged hyperglycaemia, and it is
the most common cause of a visual loss in people living with DM. The global increase
in the prevalence of DM has led to an increase in prevalence of diabetic complications,
such as DR. The primary aim of this study was to investigate the prevalence and
determinants of DR among the DM patients receiving treatment from Maruleng public
healthcare facilities, Mopani District in the Limpopo Province.
Methodology: A quantitative cross-sectional survey was used as a primary source
data from the DM patients who were readily available at the selected public healthcare
facilities to collect a chronic treatment during the time of the study. Selection of eligible
DM patients was done through a convenient sampling technique for those who were
readily available or willing to take part of the study after receiving all information about
the study for them to consent freely without any form of coercion by researcher or any
other person. All selected respondents had undergone face-to-face interviews and
basic clinical screening for DR to collect a primary source data using piloted structured
researcher-administered questionnaire to record data collected from respondents, and
calibrated medical equipment were used to measure a clinical variables during clinical
screening. Data analysis was carried out using Statistics and Data Analysis (STATA)
version 15 software for windows. The characteristics of DM patients were summarised
and analysed using a descriptive statistics. Inferential statistics were performed on
dependent variable and independent variables using a logistic regression analysis to
determine the strength of association between variables, where a potential predictors
of DR among DM patients were identified at significant level of less than 0.05 (p<0.05).
Results: Out of the 416 DM patients who participated in the study, the majority were
females (n=315; 76%) and all DM patients were above the age of 18 years, with a
mean age of 61 years (standard deviation [SD] =11.5). The overall prevalence of DR
was 35.4% comprising 32% mild non-proliferative DR (NPDR) and 3.4% moderate
NPDR. DR was found to be slightly more prevalent in females, at 35.9%, than in males,
at 34.6%; particularly in those females with type 2 DM, at 35.1%, comprising 32.1%
mild NPDR and 3% moderate NPDR. DR was more prevalent in older females, at
77.8%, comprising 55.6% mild NPDR and 22.2% moderate NPDR. The DM patients
aged 55 years and above were found to be 2.7 times more likely to develop DR, at
p<0.001, and DM patients with higher systolic blood pressure of 140 mmHg or more
were found to be 1.4 times more likely to develop DR as compared to DM patients with
a systolic blood pressure of 139 mmHg or less (≤139 mmHg), at p<0.05. Employed
DM patients were 1.4 times more likely to develop DR as compared to unemployed
DM patients, at p<0.001. Age of the DM patients, high systolic blood pressure (SBP)
or a hypertension of 140 mmHg or more (≥ 140 mmHg), and employment status were
significantly associated with higher risk of developing DR among DM patients. Gender,
hyperglycaemic state, poor glycaemic control, smoking and high BMI were found to
be associated with DR but this association was not statistically significant.
Conclusion and recommendations: Slightly more than one third of the DM patients
receiving treatment during the study period from the public healthcare facilities in the
Maruleng sub-district had some form of DR, which means that nearly four in ten DM
patients had some form of DR. Diabetic retinopathy was more prevalent in females,
and in older DM patients. Age of the DM patient, employment status, and high systolic
blood pressure were significantly associated with an increased risk of developing DR
among the DM patients. There is an urgent need to implement a health promotional
programmes to educate people about the complications of a diabetes mellitus such as
DR, and also to establish a coordinated screening programme for DR among DM
patients receiving a chronic treatment, which must be supported by the Department of
Health in all public healthcare facilities.
Keywords: Diabetes Mellitus, Diabetic Retinopathy, Prevalence, Determinants / Health and Welfare Sector Education and Training Authority (HWSETA)
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:ul/oai:ulspace.ul.ac.za:10386/3824 |
| Date | January 2021 |
| Creators | Maluleke, Khisimusi Debree |
| Contributors | Maimela, E., Ntuli, T. S. |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | xiv, 72 leaves |
| Relation |
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