Epidemiology of diabetic retinopathy and maculopathy in Africa: a systematic review
Article first published online: 17 MAR 2013
© 2012 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Volume 30, Issue 4, pages 399–412, April 2013
How to Cite
Burgess, P. I., MacCormick, I. J. C., Harding, S. P., Bastawrous, A., Beare, N. A. V. and Garner, P. (2013), Epidemiology of diabetic retinopathy and maculopathy in Africa: a systematic review. Diabetic Medicine, 30: 399–412. doi: 10.1111/j.1464-5491.2012.03756.x
- Issue published online: 17 MAR 2013
- Article first published online: 17 MAR 2013
- Accepted manuscript online: 21 JUL 2012 06:45AM EST
- Accepted 18 July 2012
Diabet. Med. 30, 399–412 (2013)
Aim To summarize findings from studies reporting the prevalence and incidence of diabetic retinopathy and diabetic maculopathy in African countries in light of the rising prevalence of diabetes mellitus.
Methods Using a predefined search strategy, we systematically searched MEDLINE, EMBASE, Science Citation index and Conference Proceedings Citation index, African Index Medicus and the grey literature database ‘OpenSIGLE’ for studies published between January 1990 and February 2011. Included studies reported prevalence or incidence of diabetic retinopathy or diabetic maculopathy of subjects with diabetes resident in African countries.
Results Sixty-two studies from 21 countries were included: three population-based surveys; two cohort studies; five case–control studies; 32 diabetes clinic-based, nine eye clinic-based and 11 other hospital-based surveys. Included studies varied considerably in terms of patient selection, method of assessing the eye and retinopathy classification. In population-based studies, the reported prevalence range in patients with diabetes for diabetic retinopathy was 30.2 to 31.6%, proliferative diabetic retinopathy 0.9 to 1.3%, and any maculopathy 1.2 to 4.5%. In diabetes clinic-based surveys, the reported prevalence range for diabetic retinopathy was 7.0 to 62.4%, proliferative diabetic retinopathy 0 to 6.9%, and any maculopathy 1.2 to 31.1%. No obvious association between prevalence and income level of the country was detected.
Conclusions Large, community-based cross-sectional and cohort studies are needed to investigate rates and determinants of prevalence of diabetic retinopathy, incidence and progression in Africa. Consensus is needed on the most appropriate methods of identification and classification of retinopathy for research and clinical practice. Estimates of prevalence of diabetic retinopathy, proliferative diabetic retinopathy and maculopathy are comparable with recent European and American studies.