Abstract
Purpose:
To describe the relation between socioeconomic status, literacy level and Diabetic Retinopathy in an urban slum population
Methods:
AJDRUMSS is an ongoing population-based, cross-sectional study in slums of Mumbai, a city of western India. Eligible subjects 40 years of age and older were studied. Data was obtained through door to door screening and a comprehensive ophthalmic examination was performed for all study participants. All participants diagnosed with T2DM underwent stereoscopic fundus photography in 7 standard Early Treatment Diabetic Retinopathy Study fields. Photographs were graded in a masked manner by a single ophthalmologist using a modified Airlie House Classification System to assess presence and severity of DR. Assessment of economic status was made on the basis of colour of Ration card issued by the Government of India. The ration card is an indicator of the services provided by the Government and the level of economic status of the households in the government’s records Literacy levels were assessed on the basis of self-reporting. Having passed middle school was considered literate.
Results:
A total of 6520 participants were interviewed during the door to door survey, of whom 721 (11.06 %) were identified with T2DM. Of the DM participants, 606 were included in economic assessment and 598 in literacy level assessment. Of the 598, prevalence of DR in illiterate was 16.7% and 17.2% in literates. Of the 606 assessed for economic status, 10 were excluded due to non availability of ration cards (homeless). 591 were middle income and 5 low income. No significant difference in prevalence of DR existed in both groups.
Conclusions:
. Literacy alone is insufficient for preventing complications of DM like DR. Awareness on the potential vision threatening complications of DM is the need of the hour. DR equally affects people of all socio economic strata. Can lead to vicious cycle of poor vision leading to decreased income generation and therefore failure for treatment.