Prevalence of disease complications and risk factor monitoring amongst diabetes and hypertension patients attending chronic disease management programmes in a South African Township.

Tiny Masupe,Peter Delobelle,Thandi Puoane,Sunday Onagbiye,Jeroen De Man

doi:10.4102/phcfm.v13i1.2997

Abstract

BackgroundSouth Africa established chronic disease management programmes (CDMPs) called ‘clubs’ to ensure quality diabetes care. However, the effectiveness of these clubs remains unclear in terms of disease risk factor monitoring and complication prevention.AimWe assessed risk factor monitoring, prevalence and determinants of diabetes related complications amongst type-2 diabetes (T2D) and hypertension (HTN) patients attending two CDMPs.SettingUrban Township in Cape Town, South Africa.MethodsCross-sectional survey combined with a 10-year retrospective medical records analysis of adult T2D/HTN patients attending two CDMPs, using a structured survey questionnaire and an audit tool. Statistical Software for Social Sciences (SPSS) version 25 was used to analyse risk factor monitoring and calculate prevalence of complications. Potential determinants of complications were explored through logistic regression.ResultsThere were 379 patients in the survey, 372 (97.9%) had HTN whilst 159 (41.9%) had T2D and HTN; 361 medical records were reviewed. Blood pressure (87.7%) and weight (86.6%) were the best monitored risk factors. Foot care (0.0% – 3.9%) and eye screening (0.0% – 1.1%) were least monitored. Nearly 22.0% of patients reported one complication, whilst 9.2% reported ≥ 3 complications. Medically recorded complications ranged from 11.1% (1 complication) to 4.2% with ≥ 3 complications. The most common self-reported and medically recorded complications were eye problems (33%) and peripheral neuropathy (16.4%), respectively. Complication occurrence was positively associated with age and female gender and negatively associated with perceived illness control.ConclusionsType-2 diabetes and hypertension patients experienced diabetes related complications and inadequate risk factor monitoring despite attending CDMPs. Increased self-management support is recommended to reduce complication occurrence.

Highlights

In the 1990–2019 global burden of disease study, high fasting plasma glucose and high body mass index (BMI) were recorded as the most increased risk exposures to health, whilst hypertension (HTN) was the risk factor that showed the largest increase accounting for 10.8 million deaths.[1]
Most data on non-communicable diseases (NCD) prevalence in South Africa comes from national surveys such as the South African National Health and Nutrition Examination Survey (SANHANES-1) conducted in 2012, which revealed an age-standardised prevalence of diabetes in South Africans aged 15 and above of 10.1%
The study population consisted of 379 patients with type-2 diabetes (T2D) and/or HTN (T2D/HTN) selected from the daily clinic attendance register in both facilities using systematic random sampling

Summary

Introduction

In the 1990–2019 global burden of disease study, high fasting plasma glucose and high body mass index (BMI) were recorded as the most increased risk exposures to health, whilst hypertension (HTN) was the risk factor that showed the largest increase accounting for 10.8 million deaths.[1] Most data on non-communicable diseases (NCD) prevalence in South Africa comes from national surveys such as the South African National Health and Nutrition Examination Survey (SANHANES-1) conducted in 2012, which revealed an age-standardised prevalence of diabetes in South Africans aged 15 and above of 10.1%.2. Prevalence rates were higher amongst the non-white people population as well as amongst women.[3] an increased mortality from diabetes was reported by the Burden of Disease Research Unit at the South African Medical Research Council[4] probably resulting from lifestyle changes, urbanisation and increasing overweight and obesity amongst South Africans.[5] According to World Health http://www.phcfm.org Open Access. The effectiveness of these clubs remains unclear in terms of disease risk factor monitoring and complication prevention

Objectives

Methods

Results

Conclusion