scholarly journals Perspectives of healthcare workers on factors influencing diabetes management and diabetic foot problems in Zimbabwe

Author(s):  
Oppah Kuguyo ◽  
Chengeto Muhaso ◽  
Simbarashe Nyandoro ◽  
Joconiah Chirenda ◽  
Vasco Chikwasha ◽  
...  
2020 ◽  
Vol 7 (11) ◽  
pp. 3623
Author(s):  
Someshwara Rao Pallela Narayana

Background: As burden of diabetes is increasing in India, so are the foot problems associated with it. Diabetic foot conditions leading to amputation are just tip of the iceberg. Patients do not present early with the complaints, hence resulting in complications. Awareness of foot care is essential in diabetes management. This prompted us to know how much is the foot care awareness among diabetic patients.Methods: This cross-sectional study was done in 120 diabetic patients selected by purposive non probability sampling method from OPD in a teaching hospital. All the patients were given a pretested questionnaire related to foot care. Total 10 questions were given each scoring one point. Patients scoring above 5 were considered good score and less than 5 were considered poor score. History of foot ulcers and present foot ailments was also taken along with these for correlation with awareness. Data was analysed by descriptive and inferential statistics.Results: Among the 120 patients, 92 (76.6%) had good knowledge and 28 (23.3%) had poor knowledge of foot care. Among the 92 patients who had good knowledge, 35 (38%) followed foot care precautions, 57 (61.9%) did not follow. Of the 57 patients 8 (14%) had foot ulcers presently. Among 28 patients with poor knowledge of foot care, 10 (35.7%) had present history of foot ulcers.Conclusions: Education in diabetic foot care and insisting on practising them on daily basis is essential to lower the incidence of grave diabetic foot conditions which may result in amputation. Prevention of foot problems by self-precautions in patients would definitely lower the complications and the financial burden.


Author(s):  
Dr. Devi Das Verma ◽  
Dr. Anil Kumar Saxena

Introduction:  Diabetes is one of the most prevalent metabolic chronic diseases due to the imbalance production of insulin. One of the studies reported that in 2010 worldwide 285 million adults had diabetes and this figure may be increase to 439 million by the year 2030. Globally Diabetic foot ulcers (DFUs) constitute major health problem in people that significantly contribute to morbidity and mortality in diabetes patients. Approximate 1.0% to 4.1% of the annual population-based incidences of a diabetic foot ulcer (DFU) were reported. Due to this the lifetime may be as high as 25%. In Asian countries diabetic foot ulcer are major problems which are different from European countries or developing countries.  From many studies reported diabetic foot problems in India are infectious and neuropathic in nature as compared to developed countries. According to World Health Organization (WHO) diabetic foot is defined as lower limb of a diabetic patient characterized by infection, potential risk of pathologic consequences ulceration or destruction of deep tissues associated with neurological abnormalities, various changes in peripheral neuropathy vasculopathy and superimposed infection that are mainly responsible foot ulceration. Ulcers are one kind of abscess which is difficult to treat because of poor wound healing that result from a combination of neuropathy, ischemia and hyperglycemia.  Aim: The main objective was to study the outcome of treatment modalities and it’s relating factors to complication in diabetic foot ulcer.  Material and method:  Total 60 diabetic foot ulcer patients with the age range from 20 to 70 years were included.  From all the patients’ detailed past and present history were recorded.  For all the patients, general, physical and local and systemic examinations were also done. Detail   laboratory examination like Fasting and Post Prandial Blood sugar levels, blood count, ECG, ESR, complete urine examination for the presence of ketone bodies and sugar, x-ray as well as culture and sensitivity of the discharge from ulcer were also done. Patients were treated with various treatment methods like conservative treatment, split skin grafting and amputation. Result: In this study male patients were more in proportion as compared to female. This study showed that maximum with the age group 14 -50 (43.3%) years old followed by 18.3% in 31-40 years old, 16.7% in 61-70 years old.  6.7% showed the least age group as 20 -30 years old.  Out of total 60 patients, 38.3% of the patients showed diabetic ulcer foot which was more whereas 15% showed diabetic gangrene foot which was least. 25% showed diabetic cellulites foot and 21.7% showed as diabetic abscess foot.  Conclusion: Globally as diabetes mellitus cases are increasing and it became rapidly the public health problem. This may be due to burden on economy, health system and on society to manage the diabetic foot problems. Diabetic foot management guidelines must be made into our practice protocols which may preventing limb loss, and decrease mortality and increase the quality of life of the patient. Hence for this it is only possible with the help of foot care education and health care workers.  Hence, foot infection is to put first and care for it like hands. Keywords: Diabetes, foot ulcers, infections, amputations.


2006 ◽  
Vol 96 (3) ◽  
pp. 245-252 ◽  
Author(s):  
Javier La Fontaine ◽  
Lawrence B. Harkless ◽  
Christian E. Davis ◽  
Marque A. Allen ◽  
Paula K. Shireman

Microvascular dysfunction is an important component of the pathologic processes that occur in diabetic foot disease. The endothelial abnormalities observed in patients with diabetes mellitus are poorly understood, and evidence suggests that endothelial dysfunction could be involved in the pathogenesis of diabetic macroangiopathy and microangiopathy. With the advent of insulin replacement in the early 1900s and increased efforts toward metabolic control of diabetes, long-term complications of this disease have become apparent. These late-term complications are primarily disorders of the vascular system. This article reviews the process of microvascular dysfunction and how it may relate to the pathogenesis of diabetic foot problems. (J Am Podiatr Med Assoc 96(3): 245–252, 2006)


2018 ◽  
Author(s):  
Usman Rabi ◽  
Ahmad A. Umar ◽  
Saheed Gidado ◽  
A.A Gobir ◽  
Izuchukwu F. Obi ◽  
...  

AbstractIntroductionEarly diagnosis and prompt and effective treatment is one of the pillars of malaria control Malaria case management guidelines recommend diagnostic testing before treatment using malaria Rapid Diagnostic Test (mRDT) or microscopy and this was adopted in Nigeria in 2010. However, despite the deployment of mRDT, the use of mRDTs by health workers varies by settings. This study set out to assess factors influencing utilisation of mRDT among healthcare workers in Zamfara State, Nigeria.MethodsA cross-sectional study was carried out among 306 healthcare workers selected using multistage sampling from six Local Government Areas between January and February 2017. Mixed method was used for data collection. A pre-tested self-administered questionnaire was used to collect information on knowledge, use of mRDT and factors influencing utilization. An observational checklist was used to assess the availability of mRDT in the six months prior to this study. Data were analyzed using descriptive statistics such as means and proportions. Association between mRDT use and independent variables was tested using Chi square while multiple regression was used to determine predictors of use at 5% level of significance.ResultsMean age of respondents was 36.0 ± 9.4years. Overall, 198 (64.7%) of health workers had good knowledge of mRDT; malaria RDT was available in 33 (61.1%) facilities. Routine use of mRDT was reported by 253 (82.7%) healthcare workers. This comprised 89 (35.2%) laboratory scientists/technicians, 89 (35.2%) community health extension workers/community health officers; 59 (23.3%) nurses and 16 (6.3%) doctors. Predictors of mRDT utilisation were good knowledge of mRDT (adjusted OR (aOR):3.3, CI: 1.6-6.7), trust in mRDT results (aOR: 4.0, CI: 1.9 - 8.2), having being trained on mRDT (aOR: 2.7, CI: 1.2 - 6.6), and provision of free mRDT (aOR: 2.3, CI: 1.0 - 5.0).ConclusionThis study demonstrated that healthcare worker utilisation of mRDT was associated with health worker and health system-related factors that are potentially modifiable. There is need to sustain training of healthcare workers on benefits of using mRDT and provision of free mRDT in health facilities.


2015 ◽  
Vol 4 (96) ◽  
pp. 16190-16194
Author(s):  
Shyamanta Das ◽  
Sashibha Barman ◽  
Navoneela Bardhan ◽  
Marami Baishya ◽  
Bornali Das ◽  
...  

2021 ◽  
Vol 8 (11) ◽  
pp. 3320
Author(s):  
Joe Mathew ◽  
Rajeev S.

Background: Diabetic foot is a very common condition responsible for a major bulk of surgical admissions and out-patient visits. Lack of awareness of many factors influencing the incidence of this disease complex has led to loss of life, limb and quality of life. The site-specific incidence of initial site and initiating factor has not been studied in diabetic foot.Methods: A study has been done over a period of one and a half years which looked into the distribution of initial site of infection in diabetic foot and associated initiating etiologies. The study was cross sectional. History, general inspection of foot, dermatological, neuropathic and vascular assessments were done, in addition to making careful notes about the site and cause of infection.Results:60.7% of patients were >60 years old, 55.3% were male patients. 63.3% of patients had diabetes for more than 10 years. In 29.3% the initial site of infection was the big toe, 22% in the ball of foot, 18% in the other 4 toes together, 14.7% in the interdigital spaces, 10.7% in the heel and 5.3% in the mid foot. In most of the cases the etiology is multifactorial, trauma in 56%, musculoskeletal deformities in 47.3%, callosities in 41.3%, cracks and fissures in 16.7%, fungal infection in 7.3%, nail infection in 6%, no initiating introduction of infection identified in 10.7%.Conclusions: Awareness of and thus particular stress being place on identification of specific site and cause of infection should help in care of the foot in diabetics.


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