Tropical diabetic hand syndrome: cases reported at the Joseph Raseta University Hospital of Befelatanana Antananarivo, Madagascar

Abstract

Introduction. The tropical diabetic hand syndrome is less reported in the literature. It corresponds to hand infections in diabetic patients. This complication is more frequent in tropical countries and in Africa. It can cause severe injury involving the functional prognosis of the hand and the vital prognosis of the patient. The aim of this article is to describe the etiology, the clinical manifestations and the management of the hand infection in our diabetic to improve the prognosis of its patients. Patients and methods. This is a retrospective descriptive study of infections of the hand in hospitalized diabetics in the Endocrinology Unity of the University Hospital of Antananarivo Befelatanana from 1rst of January 2011 to 31rst of December 2012. Results. Nine cases of tropical diabetic hand syndrome were observed among 1296 hospitalized diabetics during the study period. The sex ratio Male/Female was 0.28. The average age of patients was 50.22 years (42 - 62 years). Four patients were manual workers and four other housewives. Five lesions (55,6%) were caused by trauma. The average period of hospitalization was 17 days (6 - 30 days). Four patients presented hand cellulitis, 3 with wet gangrene of fingers and 2 presented with paronychia. The average initial blood glucose was 4.21 g/L. The amputation rate was 55.6%. The average length of stay was 13.22 days (5 - 22 days). Conclusion. The characteristics of tropical diabetic hand syndrome in Madagascar look like those of other African countries. Patient educa- tion remains a key-point to avoid the occurrence and improve the prognosis of this complication.