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Diabetic Retinopathy module for RAAB 5. David Yorston Sarah Polack Hannah Kuper Hans Limburg. Why assess DR in RAAB?. Diabetes – a growing problem. Source: International Diabetes Foundation, 2011. Diabetic retinopathy. Other 11%. Trachoma 3%. Cataract 39%. Childhood 3%. DR 4%. CO 4%.
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Diabetic Retinopathy module for RAAB 5 David Yorston Sarah Polack Hannah Kuper Hans Limburg
Diabetes – a growing problem Source: International Diabetes Foundation, 2011
Diabetic retinopathy Other 11% Trachoma 3% Cataract 39% Childhood 3% DR 4% CO 4% ARMD 7% Glaucoma 10% Refractive error 18%
What this will tell us DR module provides estimates of: • Prevalence of diabetes • Prevalence of DR and sight threatening DR in people with diabetes and in general population • Coverage of DR examinations among people with known diabetes • Levels of glycaemic control among people with diabetes ….among people aged 50+ years ….to be used to inform service planning
1. Obtain informed written consent • Explain (participant information sheet): • Purpose of study • Procedures involved • Risks (affect of dilation on vision) • Participation is voluntary • Confidentiality • Consenting participants must sign/thumb-print consent form • To be done when first arrive at the household
2. Assess diabetes (section H) Diabetes: Previous diagnosis and/or RBG ≥200mg/dl • Ask about previous diagnosis • Test random blood glucose Known diabetes: Previous diagnosis (regardless of current RBG) Newly diagnosed diabetes: No previous diagnosis, but RBG ≥200mg/dl
3. Ask questions to people with known diabetes (section I) • Age of diagnosis • Diabetes treatment • Diabetic eye exam
4. Dilated eye examination of all people with diabetes (section J) Dilated examination with direct & indirect ophthalmoscope
Obtain informed consent Standard RAAB protocol Diabetes assessment Known ‘diabetes’ Newly diagnosed ‘diabetes’ No ‘diabetes’ Finish! Ask questions about diabetes Dilate pupils Fundus examination
However! • Standard RAAB: • 4-5 days training; cost 20-40,000 US$ • RAAB + DR • 5-7 days training; cost 40-100,000 US$ • Prevalence of diabetes >20% in people 50+ • 1 team: 35 persons/day; 2 teams 60/day • Requires DR specialists and equipment • Special trainer for DR
Downloads of RAAB 5will soon be available at:www.ICEH.orgThank you!