Knowledge on the Risk Factors for Diabetic Foot Syndrome and Self-Foot Care Practices among Diabetic Patients in Tanzania

4 April, 2024

Dear HIFA colleagues,

Here are the citation and abstract of a new paper from the Tanzania Journal of Health Research, and a comment from me below.

CITATION: Jacob, E., China , E. Z., & Evaristo , M. (2024). Knowledge on the Risk Factors for Diabetic Foot Syndrome and Self-Foot Care Practices among Diabetic Patients at Muhimbili National Hospital in Dar es Salaam, Tanzania: A Cross-Sectional Study. Tanzania Journal of Health Research, 25(2), 768–784. Retrieved from https://www.ajol.info/index.php/thrb/article/view/259070

ABSTRACT

Background: Evidence indicates diabetic patients have more than 15 times increased risk of non-traumatic foot disabilities. Patients' knowledge of the potential risk factors and self-care practices anticipate better self-management.

Objective: This study aimed to assess patients’ knowledge of the risk factors for diabetic foot syndromes and reported self-foot care practices at Muhimbili National Hospital.

Methods: A hospital-based quantitative cross-sectional study design was conducted in June and December 2022. A random sampling technique was applied to recruit 140 diabetic patients at an outpatient clinic. The Guided Interview questionnaire was used to obtain data. Data were analyzed using SPSS version 25.

Result: The reported history of foot ulceration was 42(30%). Participants did not identify Smoking 106 (78.4%), foot soring/fungus 101(72.1%), and toenail ingrowth 96(68.3%) as potential contributors/risks for foot ulceration. Participants 93(66.4%) had an Inadequate knowledge score on the risk factors for Diabetic Foot Syndrome. The gender(male) (AOR: 3.71, 95%CI, 1.513-9.114, P=0.004169), education (secondary level) (AOR: 0.179, 95%CI: 0.045-0.70, P=0.0139), and history of foot ulceration (have not experienced foot ulcer) (AOR: 5.5, 95%CI: 2.14-14.165, P=0.000403) were significant associated to Inadequate knowledge score. Washing the foot with warm water and drying between the toes [daily] 84(60.4%) received poor response. Of the participants, 97(69.3%) had Good self-foot care practices. The duration of Diabetic illness (more than five months and less than one year) (AOR: 19.025, 95%CI: 2.716-133.293, P=0.003) and history of foot ulceration (have not experienced foot ulcer) (AOR: 3.377, 95%CI: 1.218-9.366, P=0.019) were significantly associated to Poor self-foot care practices.

Conclusion: The finding reveals inadequate knowledge of risk factors for diabetic foot syndromes and poor self-care practices. It gives insight into the respective authorities to develop a comprehensive rehabilitative therapy, focusing on foot health education and addressing every aspect affecting their quality of life.

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COMMENT (NPW): The paper is a reminder of the increasing burden of type 2 diabetes in sub-Saharan Africa. Optimal self-care for diabetes requires a considerable amount of information and understanding. Information needs will vary according to each patient's context. I would like to invite comments on meeting the information needs of patients with diabetes, and how this can be improved.

Best wishes, Neil

HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org