Browsing by Author "Akrofi, B."
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Item Utilization of Eye Care Services among Patients with Diabetes Attending the Endocrine Clinic of Korle Bu Teaching Hospital(University of Ghana, 2019-07) Akrofi, B.Background: Diabetes is a key public health challenge that is approaching epidemic proportion worldwide. Utilization of care services among persons diagnosed with diabetes helps in early detection of diabetic retinopathy and also, allows for timely intervention. Evidence shows that the utilization of eye care services among patients living with diabetes, in Ghana is low. Objective: To determine factors associated with utilization of eye care services among patients with diabetes, attending the endocrine clinic of Korle Bu Teaching Hospital. Method: A cross- sectional descriptive study was conducted at the endocrine clinic of Korle Bu Teaching Hospital. The study population comprised of 360 patients with established diagnosis of diabetes. Data was collected by administering a structured questionnaire to the study population between May and June, 2019. Results were analyzed using logistic regression to establish factors associated with use of eye care services. Results: The mean age of the respondents was 45 years. The proportion of respondents who visited the eye clinic within the last 12 months was 21.7%. In addition, there was a significant association between visitation of eye clinic and socio- demographic variables such as sex, age, educational status and occupation, with p-value of 0.022, 0.000, 0.021 and 0.003 respectively. The overall level of knowledge of diabetic retinopathy, among respondents was poor. More than half (58.5% ) of the respondents had no knowledge of diabetic retinopathy and the need for annual eye screening. Factors associated with utilization of eye care services revealed that, respondents with high education had higher odds of using eye care services and those with knowledge of diabetic retinopathy were also 2.7 (p=0.077 ) times more likely to utilize the eye clinic. Patients who paid for health services by both out of pocket and NHIS (p=0.031), NHIS (P=0.000) and provision of eye referral letters by physicians to respondents (p=0.024) were some of the enabling factors significantly associated with the use of eye care services. In addition, a little over two thirds of the respondents (41.1%) did not visit the eye clinic because they felt it was not necessary. Conclusion: The results suggest that, factors like education, lack of knowledge of diabetic retinopathy and the need for routine eye screening services, affordability and accessibility accounted for low proportion of patients with diabetes, receiving the recommended annual eye screening services at the eye clinic. Keywords: Diabetes, diabetic retinopathy, eye screening, use of eye care servicesItem Utilization of eye health services and diabetic retinopathy: a cross-sectional study among persons living with diabetes visiting a tertiary eye care facility in Ghana(BMC Health Services Research, 2021) Akrofi, B.; Tetteh, J.; Amissah-Arthur, K.N.; Buxton, E.N.A; Yawson, A.Background: There have been a major advance made in screening, early diagnosis, and prompt treatment of Diabetic Retinopathy among Person living with diabetes (PLWD). However, screening services remain a challenge in Low-Middle-Income-Countries where access to eye care professionals is inadequate. This study assesses the utilization of Eye Health Service prevalence (UEHS) among PLWD and associated factors and further quantifies its association with Non-Proliferative Diabetic Retinopathy (NPDR). Methods: A cross-sectional study design with a random sample of 360 PLWD was conducted at Korle-Bu Teaching Hospital, a National Referral Centre in Ghana from May to July 2019. UEHS and DR were the study outcomes. We adopted Poisson and Probit regression analysis to assess factors associated with UEHS over the past year. We employed pairwise and phi correlation (fourfold correlational analysis) to assess the relationship between UEHS and DR (ordinal and binary respectively). Ordered Logistic and Poisson regression were applied to assess the association between the UEHS and DR. Stata 16.1 was used to perform the analyses and a p-value ≤ 0.05 was deemed significant. Results: The prevalence of UEHS over the past year and DR was 21.7 %(95 %CI = 17.7–26.2) and 65.0 %(95 %CI = 59.9–69.8 respectively. The prevalence of severe NPDR with Clinically Significant Macular Edema (CSME) was 23.9 %(19.8–28.6). Type of diabetes, increasing age, educational level, mode of payment for healthcare services, marital status, years since diagnosis, and current blood glucose significantly influenced UEHS. There was a negative relationship between DR and UEHS (Pairwise and φ correlation were − 20 and − 15 respectively; p < 0.001). Non- UEHS among PLWD doubles the likelihood of experiencing severe NPDR with CSME compared with UEHS among PLWD [aOR(95 %CI) = 2.05(1.03–4.08)]. Meanwhile, the prevalence of DR among patients per non-UEHS was insignificantly higher [12 %; aPR(95 %CI) = 0.89–1.41)] compared with patients who utilized eye care health service. Conclusions: Most of the PLWD did not utilize the eye health service even once in a year and that was highly influenced by type of diabetes and increasing age. Type 2 diabetes patients and middle age decreased the likelihood of UEHS. There was a negative relationship between DR and UEHS among PLWD and this doubled the likelihood of experiencing severe NPDR with CSME. Structured health education and screening interventions are key to improving UEHS.