Evaluation of the Kenyatta National Hospital diabetic retinopathy screening program 2015-2016

Abstract

Objective: This operational evaluation was conducted to determine the effect of having a screening fundus
camera in the diabetes clinic on the demand for eye clinic diabetic retinopathy services at the Kenyatta National
Hospital (KNH).
Methods: A before-after evaluation design was used. The reference point was installation of a screening retinal
fundus camera in the KNH diabetes clinic in May 2016. The ‘before’ period was January to June 2015 and the ‘after’
period was June to November 2016. The one-year gap between the evaluation periods was used for program
development and user training. The primary measure of outcome was a comparison of the mean numbers of
patients seen and treated before and after starting the screening program. Data was obtained from the medical
records on both the diabetes and eye clinics.
Results: The total number of diabetic patients screened in the two periods was 3011 (monthly mean=502,
SD=44) and 2739 (monthly mean=457, SD=38) respectively. The total number referred to the eye clinic increased
from 494 (monthly mean=82, SD=16) to 1065 (monthly mean=178, SD=30) while the total number of patients
treated with lasers or intravitreal injections increased from 107 (monthly mean=18, SD=5) to 333 (monthly
mean=56, SD=39).
Conclusions: Starting a diabetic retinopathy screening program using a fundus camera used based at the
diabetes clinic doubled the number of patients referred for further evaluation at the eye clinic (2.2-fold increase)
and tripled the number of diabetics who received treatment for diabetic retinopathy (3.1-fold increase).