Impact of Diabetes Foot Care Education on Amputation Rate in the University of Abuja Teaching Hospital, Nigeria

Abstract

Ulceration of the foot is a major problem for people with diabetes. In a developing country like Nigeria, huge challenge is caused by diabetes foot problems. The aim of this study was to determine the impact of diabetic foot care education of patients and health care staff on the outcome of diabetic foot complications in our hospital. This was a pre and post design carried out from April 2013 to March 2014 on 155 diabetes patients. Patient education was carried out by diabetes nurses and doctors, at diagnosis and re-enforced at follow-up clinics. At the end of 1 year, the impact of education was assessed. Descriptive statistics were generated as appropriate. A total of 155 patients, 64 (41%) males and 91 (59%) females, were studied with mean age of 49 ± 3 years and mean duration of diabetes 6 ± 2.6 years. At the onset of the program, 70% of the patients had no knowledge of foot care education. Only 13.5% knew that diabetes mellitus foot ulcer could be related to long duration of diabetes, nerve damage, blood vessel blockage, foot deformity, and uncontrolled blood glucose. Ninety-two percent of the patients preferred home remedies, herbal treatment, or chemist in the event of an ulcer. After the program, 77% would seek hospital care as first option, and amputation rate decreased from 50% in 2009 to 10% by 2017. Our experience has shown that education is the cheaper option for the prevention of lower limb amputation in a resource-poor setting like ours.

Predictors of lower extremity amputation in patients with diabetic foot ulcer: findings from MEDFUN, a multi‐center observational study

“…The burden of DFU is high both in Africa generally [5], and in Nigeria in particular [6, 7]. A recent update suggests that nearly 2 out of every 10 out‐patients with diabetes in Nigeria have diabetic foot disease [7], and DFU accounts for nearly a third of diabetes‐related hospital admissions [8]. Diabetic foot ulcer is associated with prolonged hospital stay, substantial economic burden and high mortality [9, 10].…”

Upskilling programmes for unregulated care providers to provide diabetic foot screening for systematically marginalised populations: how, why and in what contexts do they work? A realist review

“…We included 52 articles spanning 39 experimental16 31–68 and 13 non-experimental articles 17 69–80. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram81 was completed to record the number of papers identified, screened and included (figure 1).…”

“…Focus: In experimental articles, 19 articles focused on diabetic foot care,31 33 34 39 43 45 47–50 55–57 60 61 63 64 67 68 and 20 articles focused on diabetes in general including foot care 16 32 35–38 40–42 44 46 51–54 58 59 62 65 66. In non-experimental articles, eight focused on diabetic foot care,69 71 73 74 76–79 and five articles focused on diabetes in general 17 70 72 75 80…”

“…Participants: Seven experimental articles focused on training patients and healthcare providers,31 33 34 55 56 61 67 seven focused on patients and family or caregivers,32 39 40 48 54 63 64 six on healthcare providers including primary care and staff,35 38 49 50 60 66 and two articles focused on CHWs 42 47. Nine articles focused on programmes led by CHWs,16 36 37 41 46 51 52 57 62 four led by peers,44 58 65 68 two by staff,45 59 one by a multidisciplinary team43 and one programme led by educators 53.…”

Autumn’s Golden Leaves

“…In Nigeria, Anumah et al 10 have demonstrated that education is an inexpensive and effective approach towards prevention of lower-limb amputations. Colak et al 11 have compared collagen granule dressings with conventional dressings in patients with DFUs, showing the benefits of the former.…”