ArticleOphthalmology2016
First Prospective Cohort Study of Diabetic Retinopathy from Sub-Saharan Africa: High Incidence and Progression of Retinopathy and Relationship to Human Immunodeficiency Virus Infection.
Article in Ophthalmology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 14 citations in OpenAlex.
- Incidence and predictors of diabetic retinopathy among patients with type 2 diabetes and hypertension: a 10-year retrospective follow-up study.Scientific reports · 2026Article
- Incidence of Diabetic Retinopathy and Its Predictors Among Newly Diagnosed Type 1 and Type 2 Diabetic Patients: A Retrospective Follow-up Study at Tertiary Health-care Setting of Ethiopia.Diabetes, metabolic syndrome and obesity : targets and therapy · 2021Article
- Comorbid hepatitis C does not modulate prevalence or severity of diabetic retinopathy.Clinical ophthalmology (Auckland, N.Z.) · 2019Article
- High mortality in subjects with both diabetes and HIV in sub-Saharan Africa.AIDS (London, England) · 2018Article
- Incidence of diabetes retinopathy and determinants of time to diabetes retinopathy among diabetes patients at Tikur Anbessa Hospital, Ethiopia: a retrospective follow up study.BMC research notes · 2018Article
- Incremental cost-effectiveness of screening and laser treatment for diabetic retinopathy and macular edema in Malawi.PloS one · 2018Observational
- Incidence and progression of diabetic retinopathy in Sub-Saharan Africa: A five year cohort study.PloS one · 2017Article
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Authors and funding
6 authors at 5 institutions in 2 countries.
Funding
Abstract
purposeTo describe the prevalence, incidence, and progression of retinopathy and to report associations with demographic, clinical, and biochemical variables in people with diabetes in Southern Malawi.
designProspective cohort study.
participantsSubjects were systematically sampled from 2 primary care diabetes clinics.
methodsWe performed the first prospective cohort study of diabetic retinopathy from Sub-Saharan Africa over 24 months. Visual acuity, glycemic control, blood pressure, human immunodeficiency virus (HIV) status, urine albumin-to-creatinine ratio, hemoglobin, and lipids were assessed. Retinopathy was graded at an accredited reading center using modified Wisconsin grading of 4-field mydriatic photographs.
main outcome measuresIncidence of sight-threatening retinopathy and progression of retinopathy by 2 steps on the Liverpool Diabetic Eye Study Scale.
resultsA total of 357 subjects were recruited to the 24-month cohort study. At baseline, 13.4% of subjects were HIV positive and 15.1% were anemic. The 2-year incidence of sight-threatening diabetic retinopathy (STDR) for subjects with level 10 (no retinopathy), level 20 (background), and level 30 (preproliferative) retinopathy at baseline was 2.7% (95% confidence interval [CI], 0.1-5.3), 27.3% (95% CI, 16.4-38.2), and 25.0% (95% CI, 0-67.4), respectively. In a multivariate logistic analysis, 2-step progression of diabetic retinopathy was associated with glycosylated hemoglobin (odds ratio [OR], 1.27; 95% CI, 1.12-1.45), baseline grade of retinopathy (OR, 1.39; 95% CI, 1.02-1.91), and HIV infection (OR, 0.16; 95% CI, 0.03-0.78). At 2 years, 17 subjects (5.8%) lost ≥15 letters.
conclusionsIncidence of STDR was approximately 3 times that reported in recent European studies. The negative association of HIV infection with retinopathy progression is a new finding.
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