Diabetes research and clinical practice · 2026
Knowledge, health beliefs, and diabetic retinopathy screening practices among adults living with diabetes in Ebonyi state, Nigeria: a community-based cross-sectional study.
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Ireka Onyekachi Jane, Okpara Chukwuemeka, Okoro Okoro Uchenna, Ogbu Nneka, Onah Emmanuel Sunday, Ukwu David, Ginger-Eke Helen, Mba Uche E
Аннотация
BACKGROUND: Diabetic retinopathy (DR) is a major preventable cause of visual impairment among people living with diabetes, yet uptake of recommended retinal screening remains low in many low- and middle-income countries. This study assessed knowledge, health beliefs, behavioural practices, and DR screening uptake among adults living with diabetes in Ebonyi State, South-Eastern Nigeria.
METHODS: A community-based cross-sectional study was conducted among adults with physician-diagnosed diabetes in selected communities in Ebonyi State. Participants completed a structured interviewer-administered questionnaire assessing DR knowledge, Health Belief Model-based health beliefs, diabetes-related behavioural practices, and previous DR screening. Knowledge was assessed using a predefined scoring system, while health beliefs were measured using five-point Likert-scale items. Descriptive statistics were used to summarize findings.
RESULTS: Among 300 participants, 183 (61.0%) were male, 201 (67.0%) lived in rural communities, and 283 (94.3%) owned a mobile phone. Knowledge of DR was limited: 111 (37.0%) knew diabetes could cause eye problems, 114 (38.0%) knew DR could cause vision loss or blindness, and 112 (37.3%) recognized that DR could occur without symptoms. Only 122 (40.7%) knew that regular eye examinations were necessary despite normal vision. Health beliefs toward screening were generally favourable, with 189 (63.0%) considering regular screening important and 156 (52.0%) considering it worth the time and cost. Only 36 (12.0%) had undergone a diabetes-specific eye examination within the preceding 12 months, while 259 (86.3%) had never been screened. Among never-screened participants, lack of physician recommendation was the most frequent reason (49.7%), followed by cost (23.0%) and lack of knowledge (11.7%).
CONCLUSIONS: Adults living with diabetes in Ebonyi State demonstrated substantial knowledge gaps and very low DR screening uptake despite generally favourable health beliefs. Strengthening patient education, routine provider recommendation, and accessible community-based screening may improve early detection and reduce avoidable vision loss.
METHODS: A community-based cross-sectional study was conducted among adults with physician-diagnosed diabetes in selected communities in Ebonyi State. Participants completed a structured interviewer-administered questionnaire assessing DR knowledge, Health Belief Model-based health beliefs, diabetes-related behavioural practices, and previous DR screening. Knowledge was assessed using a predefined scoring system, while health beliefs were measured using five-point Likert-scale items. Descriptive statistics were used to summarize findings.
RESULTS: Among 300 participants, 183 (61.0%) were male, 201 (67.0%) lived in rural communities, and 283 (94.3%) owned a mobile phone. Knowledge of DR was limited: 111 (37.0%) knew diabetes could cause eye problems, 114 (38.0%) knew DR could cause vision loss or blindness, and 112 (37.3%) recognized that DR could occur without symptoms. Only 122 (40.7%) knew that regular eye examinations were necessary despite normal vision. Health beliefs toward screening were generally favourable, with 189 (63.0%) considering regular screening important and 156 (52.0%) considering it worth the time and cost. Only 36 (12.0%) had undergone a diabetes-specific eye examination within the preceding 12 months, while 259 (86.3%) had never been screened. Among never-screened participants, lack of physician recommendation was the most frequent reason (49.7%), followed by cost (23.0%) and lack of knowledge (11.7%).
CONCLUSIONS: Adults living with diabetes in Ebonyi State demonstrated substantial knowledge gaps and very low DR screening uptake despite generally favourable health beliefs. Strengthening patient education, routine provider recommendation, and accessible community-based screening may improve early detection and reduce avoidable vision loss.