Abstract
Diabetes Mellitus (DM) foot complications are a leading cause of mortality in developing countries and the prevalence of diabetes is expected to increase in the next decades in these countries. The aim of this study was to determine the knowledge and practice of foot care among diabetes patients attending three tertiary hospitals in Nigeria. This is a cross-sectional study carried out from November 2009 to April 2010. Pre-tested structured questionnaires were administered by medical officers to diabetes patients. The outcome variables were knowledge and practice regarding foot care. The knowledge and practice scores were classified as good if score ≥70%, satisfactory if score was 50-69% and poor if score was < 50%. Of 352 diabetes patients, 30.1% had good knowledge and 10.2 % had good practice of DM foot care. Majority (78.4%) of patients with poor practice had poor knowledge of foot care. With regard to knowledge, 68.8% were unaware of the first thing to do when they found redness/bleeding between their toes and 61.4% were unaware of the importance of inspecting the inside of the footwear for objects. Poor foot practices include; 89.2% not receiving advice when they bought footwear and 88.6% failing to get appropriate size footwear. Illiteracy and low socioeconomic status were significantly associated with poor knowledge and practice of foot care. This study has highlighted the gaps in the knowledge and practice of foot care in DM patients and underscores the need for an educational programme to reduce of diabetic foot complication.
Highlights
Diabetes mellitus (DM) is a metabolic disorder that is characterized by chronic hyperglycaemia; it is a common and potentially disabling chronic disease.[1,2] The condition is presently afflicting 194 million people worldwide and is estimated to rapidly increase to 333 million people in 2025 as a consequence of longer life expectancy, sedentary lifestyle and changing dietary patterns.[2,3,4] About 60% of the poorest countries in the world are in sub-Saharan Africa and this region will experience the greatest rise in the prevalence of diabetes in the 20 year.[3]This rise in prevalence of DM is likely to bring a concomitant increase in its complications among diabetic patients
The minimum sample size of 384 was arrived at using the Cochran formula N = Z2pq d2 N = Sample Size, p = prevalence of DM in Nigeria is 2.2%. 17 The q = (1 – p), Z = standard normal deviation usually set at 1.96 which correspond to the 95% confidence interval. d = degree of accuracy desired usually set at 0.05.The calculated minimum sample size was 33 All the patients that were willing to participate in the study were recruited at the medical outpatient department and wards of the three hospitals
The result of this study showed that a greater proportion of diabetic patients had a poor knowledge of diabetic foot care
Summary
Diabetes mellitus (DM) is a metabolic disorder that is characterized by chronic hyperglycaemia; it is a common and potentially disabling chronic disease.[1,2] The condition is presently afflicting 194 million people worldwide and is estimated to rapidly increase to 333 million people in 2025 as a consequence of longer life expectancy, sedentary lifestyle and changing dietary patterns.[2,3,4] About 60% of the poorest countries in the world are in sub-Saharan Africa and this region will experience the greatest rise in the prevalence of diabetes in the 20 year.[3]This rise in prevalence of DM is likely to bring a concomitant increase in its complications among diabetic patients. One important complication of DM are the foot problems; these complications constitute an increasing public health problem and are a leading cause of admission, amputation and mortality in diabetic patients. The prevalence of diabetic foot ulcer (DFU) ranged between 1.0% and 4.1% in the United States (US), 4.6% in Kenya, and 20.4% in Netherlands.[5,6,7] Hospital-based studies demonstrated that the prevalence of limb ulceration were between 11.7% and 19.1% among individuals with diabetes in Nigeria.[8,9] The prevalence of DFU among hospitalized patients with diabetes in Iran was 20%.9
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