Evidence map›Paper›PMID 28767669›Full record

ArticlePloS one2017

Incidence and progression of diabetic retinopathy in Sub-Saharan Africa: A five year cohort study.

Philip I Burgess, Simon P Harding, Marta García-Fiñana, Nicholas A V Beare, Simon Glover, Danielle B Cohen, Gerald Msukwa, Theresa J Allain

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Observational
  4. Review
  5. Impact and Trends in Global Ophthalmology.Current ophthalmology reports · 2020
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Philip I BurgessMalawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, Blantyre, Malawi.
Simon P HardingDepartment of Eye and Vision Science, University of Liverpool, Liverpool, United Kingdom.
Marta García-FiñanaDepartment of Biostatistics, University of Liverpool, Liverpool, United Kingdom.
Nicholas A V BeareDepartment of Eye and Vision Science, University of Liverpool, Liverpool, United Kingdom.
Simon GloverMalawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, Blantyre, Malawi.
Danielle B CohenMalawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, Blantyre, Malawi.
Gerald MsukwaLions Sight First Eye Unit, Queen Elizabeth Central Hospital, Blantyre, Malawi.
Theresa J AllainCollege of Medicine, University of Malawi, Blantyre, Malawi.
University of Liverpool · GBMalawi-Liverpool-Wellcome Trust Clinical Research Programme · MWQueen Elizabeth Central Hospital · MWUniversity of Malawi · MW

Funding

Wellcome Trust
6 · The paper itself

Abstract

aimsTo describe the incidence and progression of retinopathy in people with diabetes in Southern Malawi over 5 years. To document visual loss in a setting where laser treatment is not available.

methodsSubjects from a cohort sampled from a hospital-based, primary-care diabetes clinic in 2007 were traced in 2012. Laser treatment was not available. Modified Wisconsin grading of retinopathy was performed using slit lamp biomicroscopy by a single ophthalmologist in 2007 and using four-field mydriatic fundus photographs at an accredited reading centre in 2012. Visual acuity was measured by Snellen chart in 2007 and by 'Early Treatment of Diabetic Retinopathy Study' chart in 2012. HbA1c, blood pressure, HIV status, urine albumin-creatinine ratio, haemoglobin and lipids were measured.

resultsOf 281 subjects recruited in 2007, 135 (48%) were traced and assessed, 15 were confirmed dead. At follow-up (median 5.3 years) ≥2 step retinopathy progression was observed in 48 subjects (36.4%; 95% CI 28.2-44.6). Incidence of sight threatening diabetic retinopathy for those with level 10 (no retinopathy) and level 20 (background) retinopathy at baseline, was 19.4% (11.3-27.4) and 81.3% (62.1-100), respectively. In multivariate analysis 2 step progression was associated with HbA1c (OR 1.2495%CI 1.04-1.48), and haemoglobin level (0.77, 0.62-0.98). 25 subjects (18.8%) lost ≥5 letters, 7 (5.3%) lost ≥15 letters.

conclusionsProgression to sight threatening diabetic retinopathy from no retinopathy and background retinopathy was approximately 5 and 3 times that reported in recent European studies, respectively. Incidence of visual loss was high in a location where treatment was not available.

Indexed as

AgedCohort StudiesDiabetic RetinopathyDisease ProgressionFemaleGlycated HemoglobinHemoglobinsHumansIncidenceMalawiMaleMiddle AgedGlycated Hemoglobinhemoglobin A1c protein, humanHemoglobins

Identifiers

PMID28767669
PMCPMC5540405
OpenAlexW2739892644

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.