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S Afr Med J. 2007 Dec;97(12):1284-8.

Screening for diabetic retinopathy in primary care with a mobile fundal camera--evaluation of a South African pilot project.

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  • 1Division of Family Medicine and Primary Care, Department of Interdisciplinary Health Sciences, Stellenbosch University, Tygerberg, W Cape. rm@sun.ac.za

Abstract

BACKGROUND AND AIMS:

In South Africa diabetes makes a significant contribution to the burden of disease. Diabetic retinopathy is a leading cause of adult blindness, and screening can reduce the incidence. This project aimed to implement and evaluate a new service for retinal screening that uses a non-mydriatic mobile fundal camera in primary care. This is the first time such a service has been evaluated in an African primary care context.

METHODS:

The service was implemented as an operational research study at three community health centres and data were collected to evaluate the operational issues, screening, reporting and referral of patients.

RESULTS:

Out of 400 patients screened 84% had a significantly reduced visual acuity, 63% had retinopathy (22% severe nonproliferative, 6% proliferative and 15% maculopathy), 2% of eyes could not be screened and 14% of patients required dilatation. Referral was necessary in 27% of cases for cataracts, in 7% for laser treatment and in 4% for other specialist services. Repeat photography was needed in 8% and urgent follow-up in 12%. A SWOT analysis of the pilot project was completed and recommendations were made on how to integrate it into the district health system.

CONCLUSION:

Screening with a fundal camera improved the quality of care for diabetic patients and is feasible in the South African public sector, primary care setting. A single technician should be able to photograph almost 10,000 patients a year.

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PMID:
18264611
[PubMed - indexed for MEDLINE]
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