The project seeks to prevent, screen and treat diabetes-related ophthalmic complications in order to reduce the incidence of blindness linked to diabetes.
Expected impact
Training of 4 ophthalmologists 3 internists/diabetologists, 6 nurses, 3 dieticians and 12 educators
Raising awareness in the general population through screening and treatment of diabetic retinopathy
8,640 patients screened for diabetic retinopathy and treated where needed
6,048 angiographs performed
1,814 photocoagulations conducted
Results to date
The Yaoundé and Bamenda clinics are fully operational with both angiography and photocoagulation. The Garoua clinic has a functional angiograph.
7 ophthalmologists, 4 internists, 6 ophthalmology nurses, and 12 educators have been trained. The Yaoundé clinic staff has been trained in use of the equipment. A diabetes doctor and nurse from the Garoua clinic have undergone one week's training in the use of the angiograph.
9,956 patients have been screened for diabetic retinopathy of which 1,882 were detected with diabetic retinopathy. 4,706 angiographs have been performed; and 1,102 laser treatments (photocoagulations) have been performed. The cost is lowered to EUR 7.5 and EUR 15 respectively to allow low-income patients to access treatment.
At the Yaoundé clinic two weekly group education sessions are held for diabetic patients. Eye nurses conduct other sessions during examination and consultation, and awareness sessions take place during group discussions.
713 people have been screened for diabetes by outreach agents, 98 cases of diabetes were detected.
A patient education/sensitisation film on diabetic retinopathy and the need for screening has been developed in French and been translated into English.
Public awareness messages have been developed in English and French for flyers to be distributed at clinics and in community settings.
Project details
Diabetic retinopathy constitutes one of the serious complications caused by diabetes. In Cameroon, diabetic retinopathy occurs in 37.5% of people living with diabetes and is responsible for 3.2% of people with diabetes turning blind and 9.4% suffering from partial sight.
Prevalence of diabetes is estimated at 6% of the adult population in Cameroon (WHO Steps survey 2005), compared with 40% for malaria or 5.5% for HIV among the sexually active population.
Cameroon has developed a health sector strategy (2001-2010) with the main aim of reducing mortality among Cameroon’s population by one third. Disease prevention and control programmes have been formulated; including a National Programme for Prevention of Blindness. This Programme has as its objective to reduce the prevalence of blindness linked to diabetes and high blood pressure by 50% by 2020.
Approach
This government project is lead by the Ministry of Public Health and supported jointly by the National Programme for the Prevention of Blindness and the National Diabetes/Hypertension Prevention and Control Programme.
Partners in the project include the Ministry of Public Health, Cameroon Burden of Diabetes Project, the Cameroon Diabetes Association (ACADIA) and Geneva University Hospital.
The project applies a two-pronged approach; focusing on public awareness of diabetic eye complications as well as building health care capacity for treatment of these complications.
In the area of strengthening health care capacity, at the outset of the project, advanced eye care was only available at the tertiary hospital in Douala. This project builds capacity for eye care in a total of 4 existing public health facilities in the cities of Yaoundé, Bamenda and Garoua. Staff and facilities are allocated by the Ministry of Public Health and the participating health facilities.
Eye care facilities will commence operation following training of relevant staff (ophthalmologists, diabetologists, nurses, dieticians and educators) and provision of advanced equipment to the health facilities. The eye care facilities are closely linked to the existing diabetes/hypertension clinics; implemented under WDF02-016 and WDF05-117.
Training will be done by local experts as well as Geneva University Hospital which will also provide technical support a.o. through telemedicine.
All diabetes patients visiting the existing diabetes clinics are systematically directed to the eye care facility for registration and regular, nurse-lead check-ups. The patient file is submitted to the ophthalmologist to be interpreted and the results are sent to the diabetologist. If necessary, the patient is called up for a further examination or for laser treatment.
In the area of public awareness of diabetes related eye complications, the project arranges targeted awareness campaigns and uses peer educators recruited within the Cameroon diabetes association, ACADIA. The peer educators are trained and work to ensure the spreading of awareness and social mobilisation in the local communities.
Data will be compiled by the head nurse in the eye care facility on a monthly basis and sent to the project coordinator.
