Prevention and treatment of diabetic retinopathy, Cameroon

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.

Objective

The project seeks to prevent, diagnose and treat diabetes related eye complications in order to reduce the incidence of blindness linked to diabetes.

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.

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

• 7 ophthalmologists, 4 internists /diabetologists, 6 ophthalmology nurses, and 4 educators have been retrained prior to opening of sites.
• 3 educational audiovisual documentaries have been produced.
• The clinic in Yaoundé Central Hospital has opened and is functional. A fluorescent angiograph has been installed at the eye clinic in Garoua Provincial Hospital.
• 296 angiographies and 13 laser treatments have been realised mainly at the Yaoundé site and to some extent at the Garoua site.
• At the Yaoundé site 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.

Project data

Area Partner Project responsible      Duration Project budget WDF contribution Project number

Cameroon Ministry of Public Health Prof. A. L. F. Bella April 2007 – March 2009 EUR 901,087 EUR 600,000 WDF06-177

This page was last updated 10-2-2008 by bisl.wdf