Prevalence of diabetic retinopathy and its associated risk factors among adults in Ethiopia: a systematic review and meta-analysis

Abstract

Diabetic retinopathy is a complication of diabetes mellitus and a leading cause of blindness and visual impairment globally. Limited information existed on the epidemiology of diabetic retinopathy at the national level in Ethiopia. Thus, the objective of this review was to determine the pooled prevalence of diabetic retinopathy and its associated risk factors in Ethiopia. A systematic review and meta-analysis was conducted using previous primary studies that were found in electronic databases such as Web of Science, Scopus, PubMed, CINHAL, Google Scholar, and online African journals. We evaluated the quality of the included studies using the Newcastle-Ottawa Assessment Scale. The random-effects model was applied because heterogeneity was expected. I-Square and the Cochrane Q statistics were used to evaluate heterogeneity. Publication bias was examined using Egger’s test and a funnel plot. A random-effect meta-analysis was applied to pool the odds ratios of risk factors to determine the association between the independent and dependent variables. After 598 articles were found, 22 studies that met the eligibility requirements were included. The pooled prevalence of retinopathy among patients with diabetes in Ethiopia was 24.35% (95% CI: 18.88–29.83), with considerable heterogeneity (I2 = 98.18%, p < 0.001). Ten years and longer with diabetes (AOR = 4.36, 95% CI: 1.71–7.01), hypertension (AOR = 2.54, 95% CI: 1.45–3.63), poor glycemic control (AOR = 3.83, 95% CI: 1.62–6.04), and positive proteinuria (AHR = 1.55, 95% CI: 1.02–2.07) were risk factors for diabetic retinopathy. Retinopathy affects one in four patients with diabetes. Diabetic patients with longer duration, hypertension, poor glycemic control, and positive proteinuria should receive special care.