Article Text

Download PDFPDF
Rapid assessment of avoidable blindness and diabetic retinopathy in people aged 50 years and older in the National Capital District of Papua New Guinea
  1. Anthea Burnett1,2,
  2. Ling Lee1,2,
  3. Fabrizio D'Esposito3,
  4. Geoffrey Wabulembo4,
  5. Anaseini Cama5,
  6. Georgia Guldan6,
  7. Marleen Nelisse7,
  8. Samuel Peter Koim8,
  9. Drew Keys1,8,9,10,
  10. Alison J Poffley1,
  11. Hans Limburg11,
  12. Jambi Garap8,10
  1. 1 Brien Holden Vision Institute, Sydney, New South Wales, Australia
  2. 2 School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
  3. 3 Fred Hollows Foundation, Melbourne, Victoria, Australia
  4. 4 CBM, Port Moresby, Papua New Guinea
  5. 5 Pacific Trachoma Initiative, The Fred Hollows Foundation, Sydney, New South Wales, Australia
  6. 6 School of Medical and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea
  7. 7 Fred Hollows Foundation, Auckland, New Zealand
  8. 8 PNG Eye Care, Port Moresby, Papua New Guinea
  9. 9 International Agency for the Prevention of Blindness, London, UK
  10. 10 National Prevention of Blindness Committee, Port Moresby, Papua New Guinea
  11. 11 Health Information Services, Grootebroek, The Netherlands
  1. Correspondence to Dr Anthea Burnett, Brien Holden Vision Institute, Sydney, New South Wales 2052, Australia; a.burnett{at}


Background/aims To conduct an assessment of avoidable blindness, diabetes mellitus and diabetic retinopathy (DR) in adults aged 50 years and older in the National Capital District (NCD) region of Papua New Guinea (PNG).

Methods A cross-sectional population-based survey was performed for which 25 clusters of 50 people aged ≥50 years were randomly selected from the NCD region. The standardised rapid assessment of avoidable blindness (RAAB) with diabetic retinopathy (+DR) methodology was used. Blindness was defined as presenting visual acuity <3/60 in the better eye. Participants were classified as having diabetes if they were known to have diabetes or if their random blood glucose level was ≥200 mg/dL. Dilated fundus examination and Scottish DR grading were performed.

Results In total, 1192 out of 1250 eligible participants (95.4%) were examined. Of these, 7.8% had known or newly diagnosed diabetes. Seventy-one per cent of participants with known diabetes had a blood glucose level ≥200 mg/dL, and 82.9% had never had an ophthalmological examination for DR. Prevalence of DR and/or maculopathy was 46.4%. The age-adjusted and sex-adjusted prevalence of diabetes was estimated at 8.1% (95% CI 5.7% to 10.4%) in the population aged 50 years or older in the NCD region of PNG.

Conclusions Prevalence of diabetes in adults aged 50 years and older was lower than reported elsewhere in the region, and lower than other RAAB+DR surveys. Despite this, the prevalence of DR is high compared with other RAAB+DR surveys and demonstrates the need for increased awareness and accessibility to eye services for people with diabetes.

  • rapid assessment of avoidable blindness
  • diabetic retinopathy
  • Papua New Guinea
  • epidemiology

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors AB, LL, FD, GW, AC, MN, SPK, DK, HL and JG designed and conducted the survey. AB, LL, FD and HL analysed the data. LL, FD, AP, HL and AB prepared the manuscript. All authors edited and reviewed the manuscript, and agree with the final version of the manuscript and agree to be accountable for all aspects of the work.

  • Funding Supported by the Fred Hollows Foundation, Sydney, Australia.

  • Competing interests None declared.

  • Patient consent Parental/guardian consent obtained.

  • Ethics approval Ethical approval for the study was obtained from the University of New South Wales Human Research Ethics Committee (HC16804), and the Government of PNG Medical Research Advisory Committee (MRAC No.16.35).

  • Provenance and peer review Not commissioned; externally peer reviewed.

Linked Articles

  • At a glance
    Keith Barton James Chodosh Jost B Jonas