Artificial Intelligence for DR detection in LMICs

The early diagnosis and treatment of Diabetic Retinopathy (DR) is known to preserve vision; this is done successfully in the UK through the national DR screening programme. However, there are very few DR screening programmes in Africa, and those that do exist suffer from a shortage of specialist eye care staff and high rates of loss to follow-up.

In Tanzania, we are running a clinical trial to assess whether using artificial intelligence (AI) in a real-world programme can improve DR screening outcomes for patients and help prevent people losing vision from DR.

Currently, people within the DR service in this region of Tanzania may have to wait several days or weeks for a doctor back at a hospital to analyse their retinal image and be told they have DR and require follow-up treatment. This creates time in which people are lost to services and don’t return for treatment. AI diagnosis at the point of screening can reduce this waiting time and increase the amount of people who attend care.

By automating the clinical decision making (in a validated manner), using AI also reduces the pressure on the workforce. Trained doctors at the hospital can spend less time analysing images or travelling to remote clinics, while local health workers can use the AI systems quickly and easily.

This study aims to provide evidence for the use of AI for this condition in other similar low resource areas, improving care for DR where people need it most.

The project results are expected later in 2025.

Publications

Cleland CR, Bascaran C, Makupa W, et al. Artificial intelligence-supported diabetic retinopathy screening in Tanzania: rationale and design of a randomised controlled trial. BMJ Open. 2024;14:e075055. https://dx.doi.org/10.1136/bmjopen-2023-075055

Acknowledgments

Our partners for the project are the Kilimanjaro Christian Medical Centre in Moshi and Muhimbili Hospital in Dar es Salaam. Funding is from the British Council for the Prevention of Blindness (BCPB), Christian Blind Mission (CBM) and Sir Halley Stewart Trust.