Prevalence and risk factors for diabetic foot complications among people living with diabetes in Harare, Zimbabwe: a cross-sectional study
Abstract Background Diabetic foot disease (DF) is a common diabetes-related complication; however, the prevalence and associated risk factors for DF are not well characterised among people living with diabetes (PLWD) in Zimbabwe. This may suggest the unavailability of adequate strategies to diagnose...
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BMC
2024-03-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-023-17610-7 |
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| author | Oppah Kuguyo Doreen Macherera Mukona Vasco Chikwasha Lovemore Gwanzura Joconiah Chirenda Alice Matimba |
| author_facet | Oppah Kuguyo Doreen Macherera Mukona Vasco Chikwasha Lovemore Gwanzura Joconiah Chirenda Alice Matimba |
| author_sort | Oppah Kuguyo |
| collection | DOAJ |
| description | Abstract Background Diabetic foot disease (DF) is a common diabetes-related complication; however, the prevalence and associated risk factors for DF are not well characterised among people living with diabetes (PLWD) in Zimbabwe. This may suggest the unavailability of adequate strategies to diagnose and treat DF in the country. This study aimed to determine the prevalence of DF and associated risk factors for PLWD in Harare, Zimbabwe. Methods This was a cross-sectional study, employing a quantitative approach. In total, 352 PLWD were recruited from 16 primary care clinics in Harare. Sociodemographic and clinical data were collected via face-to-face interviews and clinical records reviews. The DF screening included an evaluation for peripheral neuropathy, ankle-brachial index (ABI), ulceration, and amputation. Self-administered questionnaires were used to assess knowledge, attitudes, and practices (KAPs), and KAP was scored using Bloom’s cut-off. Chi-Square goodness-of-fit tests were performed, and regression analyses were used for association analysis. The threshold for significance was p < 0.05. Results This group included 82 men and 279 women, with a combined mean age of 57.9 ± 14 years. Twenty one (~ 26%) men and 41 (15%) women had type 1 diabetes. The diabetes type distribution significantly differed by gender (p < 0.001). Oral hypoglycaemics (71%) were most commonly administered for management. DF was observed in 53% (95% CI = 50–56) of PLWD. Other DF symptoms observed were abnormal ABI (53%), peripheral neuropathy (53%), foot ulceration (17%) and amputation (3%). Peripheral neuropathy increased the risk of ulceration (OR = 1.7; 95% CI = 1.1–2.6; p = 0.019), while insulin use was protective against amputation (OR = 0.1; 95% CI = 0.1–0.9; p = 0.049). Most (87%) of the participants demonstrated good DF knowledge and the importance of adhering to medication to prevent DF. However, 96% did not know that smoking was a risk factor for DF. Nearly two-thirds (63%) demonstrated poor attitudes and practices. Poor attitudes and practices were not predictors of DF ulceration risk (p > 0.05). Conclusion This study showed that there was a high prevalence of DF (53%) in PLWD in Zimbabwe, and insulin use was protective against DF. There is an urgent need for policy revisions to include foot screening in routine primary care and increasing insulin use for PLWD to prevent complications such as DF as an integral part of primary care. |
| first_indexed | 2024-03-07T14:36:34Z |
| format | Article |
| id | doaj.art-18cce929a82d4c2392582850ef8f6b02 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-03-07T14:36:34Z |
| publishDate | 2024-03-01 |
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| spelling | doaj.art-18cce929a82d4c2392582850ef8f6b022024-03-05T20:37:17ZengBMCBMC Public Health1471-24582024-03-0124111310.1186/s12889-023-17610-7Prevalence and risk factors for diabetic foot complications among people living with diabetes in Harare, Zimbabwe: a cross-sectional studyOppah Kuguyo0Doreen Macherera Mukona1Vasco Chikwasha2Lovemore Gwanzura3Joconiah Chirenda4Alice Matimba5Department of Clinical Pharmacology, Faculty of Medicine and Health Sciences, University of ZimbabweDepartment of Primary Care Sciences, Faculty of Medicine and Health Sciences, University of ZimbabweDepartment of Community Medicine, Faculty of Medicine and Health Sciences, University of ZimbabweDepartment of Medical Laboratory Sciences, Faculty of Medicine and Health Sciences, University of ZimbabweDepartment of Community Medicine, Faculty of Medicine and Health Sciences, University of ZimbabweDepartment of Clinical Pharmacology, Faculty of Medicine and Health Sciences, University of ZimbabweAbstract Background Diabetic foot disease (DF) is a common diabetes-related complication; however, the prevalence and associated risk factors for DF are not well characterised among people living with diabetes (PLWD) in Zimbabwe. This may suggest the unavailability of adequate strategies to diagnose and treat DF in the country. This study aimed to determine the prevalence of DF and associated risk factors for PLWD in Harare, Zimbabwe. Methods This was a cross-sectional study, employing a quantitative approach. In total, 352 PLWD were recruited from 16 primary care clinics in Harare. Sociodemographic and clinical data were collected via face-to-face interviews and clinical records reviews. The DF screening included an evaluation for peripheral neuropathy, ankle-brachial index (ABI), ulceration, and amputation. Self-administered questionnaires were used to assess knowledge, attitudes, and practices (KAPs), and KAP was scored using Bloom’s cut-off. Chi-Square goodness-of-fit tests were performed, and regression analyses were used for association analysis. The threshold for significance was p < 0.05. Results This group included 82 men and 279 women, with a combined mean age of 57.9 ± 14 years. Twenty one (~ 26%) men and 41 (15%) women had type 1 diabetes. The diabetes type distribution significantly differed by gender (p < 0.001). Oral hypoglycaemics (71%) were most commonly administered for management. DF was observed in 53% (95% CI = 50–56) of PLWD. Other DF symptoms observed were abnormal ABI (53%), peripheral neuropathy (53%), foot ulceration (17%) and amputation (3%). Peripheral neuropathy increased the risk of ulceration (OR = 1.7; 95% CI = 1.1–2.6; p = 0.019), while insulin use was protective against amputation (OR = 0.1; 95% CI = 0.1–0.9; p = 0.049). Most (87%) of the participants demonstrated good DF knowledge and the importance of adhering to medication to prevent DF. However, 96% did not know that smoking was a risk factor for DF. Nearly two-thirds (63%) demonstrated poor attitudes and practices. Poor attitudes and practices were not predictors of DF ulceration risk (p > 0.05). Conclusion This study showed that there was a high prevalence of DF (53%) in PLWD in Zimbabwe, and insulin use was protective against DF. There is an urgent need for policy revisions to include foot screening in routine primary care and increasing insulin use for PLWD to prevent complications such as DF as an integral part of primary care.https://doi.org/10.1186/s12889-023-17610-7DiabetesDiabetic footDiabetic foot in ZimbabwePeripheral neuropathyInsulin |
| spellingShingle | Oppah Kuguyo Doreen Macherera Mukona Vasco Chikwasha Lovemore Gwanzura Joconiah Chirenda Alice Matimba Prevalence and risk factors for diabetic foot complications among people living with diabetes in Harare, Zimbabwe: a cross-sectional study BMC Public Health Diabetes Diabetic foot Diabetic foot in Zimbabwe Peripheral neuropathy Insulin |
| title | Prevalence and risk factors for diabetic foot complications among people living with diabetes in Harare, Zimbabwe: a cross-sectional study |
| title_full | Prevalence and risk factors for diabetic foot complications among people living with diabetes in Harare, Zimbabwe: a cross-sectional study |
| title_fullStr | Prevalence and risk factors for diabetic foot complications among people living with diabetes in Harare, Zimbabwe: a cross-sectional study |
| title_full_unstemmed | Prevalence and risk factors for diabetic foot complications among people living with diabetes in Harare, Zimbabwe: a cross-sectional study |
| title_short | Prevalence and risk factors for diabetic foot complications among people living with diabetes in Harare, Zimbabwe: a cross-sectional study |
| title_sort | prevalence and risk factors for diabetic foot complications among people living with diabetes in harare zimbabwe a cross sectional study |
| topic | Diabetes Diabetic foot Diabetic foot in Zimbabwe Peripheral neuropathy Insulin |
| url | https://doi.org/10.1186/s12889-023-17610-7 |
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