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Table 3 Distribution of personnel, workload, and diabetic retinopathy treatment services in Ghana

From: Situational analysis of diabetic retinopathy treatment Services in Ghana

Variable

Setting

Facility type

Regions

 

Rural

Urban

Public

CHAG

Private

GAR

AR

NR

BAR

VR

 

n (%)

n (%)

n (%)

n (%)

n (%)

n (%)

n (%)

n (%)

n (%)

n (%)

Health professionals treating DR

 Vitreoretinal surgeon

0 (0.0)

11 (100.0)

4 (36.36)

1 (9.09)

6 (54.55)

10 (90.9)

1 (9.1)

0 (0.0)

0 (0.0)

0 (0.0)

 Ophthalmologist

4 (21.1)

15 (78.9)

6 (31.6)

3 (15.8)

10 (52.6)

10 (52.63)

4 (21.05)

3 (15.79)

1 (5.26)

1 (5.26)

 Optometrist

0 (0.0)

1 (100.0)

0 (0.0)

0 (0.0)

1 (100)

1 (100.0)

0 (0.0)

0 (0.0)

0 (0.0)

0 (0.0)

 Ophthalmic nurse

3 (37.5)

5 (62.5)

0 (0.0)

3 (37.5)

5 (62.5)

5 (62.5)

0 (0.0)

0 (0.0)

0 (0.0)

3 (37.5)

DRT

 Retinal laser photocoagulation

3 (30.0)

7 (70.0)

2 (20.0)

3 (30.0)

5 (50.0)

6 (60.0)

1 (10.0)

1 (10.0)

1 (10.0)

1 (10.0)

 Anti-VEGF

1 (9.1)

11 (90.9)

4 (33.33)

1 (8.33)

7 (58.33)

7 (58.3)

3 (25.0)

2 (16.7)

0 (0.0)

0 (0.0)

 Vitreoretinal surgery

0 (0.0)

6 (100.0)

2 (33.3)

0 (0.0)

4 (66.7)

5 (83.3)

1 (16.7)

0 (0.0)

0 (0.0)

0 (0.0)

Guidelines for DRT

  

3 (33.3)

       

 ICO guidelines

1 (16.7)

5 (83.3)

2 (33.3)

1 (16.7)

3 (50.0)

2 (33.3)

2 (33.3)

1 (16.7)

1 (16.7)

0 (0.0)

 Clinical expertise

3 (25.0)

9 (75.0)

4 (33.3)

3 (25.0)

5 (41.7)

5 (41.7)

3 (25.0)

2 (16.7)

1 (8.3)

1 (8.3)

Routine diabetic examination

2 (28.6)

5 (71.4)

3 (42.86)

2 (28.57)

2 (28.57)

4 (57.14)

0 (0.0)

1 (14.29)

1 (14.29)

1 (14.3)

Referral pathway

 One-way

0 (0.0)

5 (100.0)

1 (20.0)

1 (20.0)

3 (60.0)

4 (80.0)

1 (20.00)

0 (0.0)

0 (0.0)

0 (0.0)

 Reciprocal

3 (33.3)

6 (66.7)

3 (33.33)

2 (22.22)

4 (44.44)

3 (33.33)

2 (22.22)

2 (22.22)

1 (11.11)

1 (11.1)

Records availability

3 (27.3)

8 (72.7)

2 (18.18)

3 (27.27)

6 (54.55)

5 (45.45)

2 (18.18)

2 (18.18)

1 (9.09)

1 (9.09)

Number of people treated

 Retinal laser

33 (1.9)

1669 (98.1)

293 (17.22)

117 (6.87)

1292 (75.91)

1461 (85.84)

208 (12.22)

5 (0.29)

10 (0.59)

18 (1.1)

 Anti-VEGF

15 (0.8)

1953 (99.2)

268 (13.62)

124 (6.30)

1576 (80.08)

1716 (87.20)

229 (11.64)

23 (1.17)

0 (0.0)

0 (0.0)

 Vitreoretinal surgery

0 (0.0)

407 (100.0)

22 (5.41)

21 (5.16)

364 (89.43)

407 (100.0)

0 (0.0)

0 (0.0)

0 (0.0)

0 (0.0)

Number of eyes treated

 Retinal laser photocoagulation

37 (1.3)

2910 (98.7)

406 (13.78)

117 (3.97)

2424 (82.25)

2589 (87.85)

321 (10.89)

9 (0.31)

10 (0.34)

18 (0.6)

 Anti-VEGF

21 (0.6)

3435 (99.4)

338 (9.78)

124 (3.59)

2994 (86.63)

3103 (89.79)

318 (9.20)

35 (1.01)

0 (0.0)

0 (0.0)

 Vitreoretinal surgery

0 (0.0)

533 (100.0)

22 (4.13)

21 (3.94)

490 (91.93)

533 (100.0)

0 (0.0)

0 (0.0)

0 (0.0)

0 (0.0)

Checklist for DRT services

 Screening protocols for DM

2 (28.6)

5 (71.4)

4 (57.14)

1 (14.29)

2 (28.57)

3 (42.86)

1 (14.29)

2 (28.57)

1 (14.29)

0 (0.00

 Screening protocols for DR

1 (11.1)

8 (88.9)

4 (44.44)

1 (11.11)

4 (44.44)

6 (66.67)

1 (11.11)

2 (22.22)

0 (0.0)

0 (0.0)

 Grading protocols for DR

1 (11.1)

8 (88.9)

4 (44.44)

1 (11.11)

4 (44.44)

6 (66.67)

1 (11.11)

2 (22.22)

0 (0.0)

0 (0.0)

 Treatment protocols for DR

1 (11.1)

8 (88.9)

4 (44.44)

1 (11.11)

4 (44.44)

6 (66.67)

1 (11.11)

2 (22.22)

0 (0.0)

0 (0.0)

 DR treatment registry/records

2 (18.2)

9 (81.8)

3 (27.27)

2 (18.18)

6 (54.55)

7 (63.64)

1 (9.09)

2 (18.18)

1 (9.09)

0 (0.0)

 Anti-VEGF drugs

1 (8.3)

11 (91.7)

4 (33.33)

1 (8.33)

7 (58.33)

7 (58.33)

3 (25.00)

2 (16.67)

0 (0.0)

0 (0.0)

 27 needle and 1 ml syringe

2 (15.4)

11 (84.6)

4 (30.77)

2 (15.38)

7 (53.85)

7 (53.85)

3 (23.08)

2 (15.38)

0 (0.0)

1 (7.69)

 Operating microscope

3 (21.4)

11 (78.6)

4 (28.57)

3 (21.43)

7 (50.00)

7 (50.00)

3 (21.43)

2 (14.29)

1 (7.14)

1 (7.14)

 Retinal Laser machine

2 (20.0)

8 (80.0)

3 (30.00)

3 (30.00)

4 (40.00)

7 (70.00)

1 (10.0)

0 (0.0)

1 (10.00)

1 (10.0)

 Vitrectomy machine

1 (12.5)

7 (87.5)

2 (25.00)

2 (25.00)

4 (50.00)

6 (75.00)

1 (12.5)

0 (0.0)

0 (0.0)

1 (12.5)

 Fundus/retinal camera

2 (22.2)

7 (77.8)

2 (22.22)

2 (22.22)

5 (55.56)

5 (55.56)

2 (22.22)

1 (11.11)

1 (11.11)

0 (0.0)

 OCT machine

0 (0.0)

7 (100.0)

3 (42.86)

1 (14.29)

3 (42.86)

6 (85.7)

1 (14.3)

0 (0.0)

0 (0.0)

0 (0.0)

 Pan retinal photocoagulation lens

1 (10.0)

9 (90.0)

3 (30.0)

2 (20.0)

5 (50.0)

7 (70.00)

2 (20.00)

0 (0.0)

0 (0.0)

1 (10.0)

 FFA/ICG angiography

1 (16.7)

5 (83.3)

2 (33.3)

1 (16.7)

3 (50.0)

4 (66.67)

1 (16.67)

0 (0.0)

0 (0.0)

1 (16.7)

 Slit lamp biomicroscope

3 (21.4)

11 (78.6)

4 (28.6)

3 (21.4)

7 (50.0)

7 (50.0)

3 (21.43)

2 (14.29)

1 (7.14)

1 (7.14)

 Direct ophthalmoscope

3 (21.4)

11 (78.6)

4 (28.6)

3 (21.4)

7 (50.0)

7 (50.00)

3 (21.43)

2 (14.29)

1 (7.14)

1 (7.14)

 Indirect ophthalmoscope

3 (21.4)

11 (78.6)

4 (28.6)

3 (21.4)

7 (50.0)

7 (50.00)

3 (21.43)

2 (14.29)

1 (7.14)

1 (7.14)

 90 D lens

3 (23.08)

10 (76.92)

4 (30.77)

3 (23.08)

6 (46.15)

7 (53.85)

2 (15.38)

2 (15.38)

1 (7.69)

1 (7.69)

 78 D lens

2 (15.4)

11 (84.6)

4 (30.77)

2 (15.38)

7 (53.85)

7 (53.85)

3 (23.08)

2 (15.38)

1 (7.69)

0 (0.0)

 20 D lens

3 (21.4)

11 (78.6)

4 (28.57)

3 (21.43)

7 (50.0)

7 (50.0)

3 (21.43)

2 (14.29)

1 (7.14)

1 (7.14)

 Three-mirror contact lens

2 (16.7)

10 (83.3)

4 (33.3)

2 (16.7)

6 (50.0)

7 (58.33)

2 (16.67)

2 (16.67)

0 (0.0)

1 (8.33)

 Visual acuity chart

3 (21.4)

11 (78.6)

4 (28.6)

3 (21.4)

7 (50.0)

7 (50.0)

3 (21.43)

2 (14.29)

1 (7.14)

1 (7.14)

  1. n frequency, % percentage frequency, CHAG Christian Health Association of Ghana, GAR Greater Accra Region, AR Ashanti Region, NR Northern Region, BAR Brong Ahafo Region, VR Volta Region, DRT Diabetic Retinopathy Treatments, Anti-VEGF Anti-vascular endothelial growth factor therapy, DM Diabetes mellitus, DR Diabetic retinopathy, OCT Optical Coherence Tomography, FFA Fluorescein Angiography, ICG Indocyanine Green, D Dioptres; Workload is defined as the total number of eyes treated for DR using retinal lasers, Anti-VEGF or by VR surgery