Prevalence, Screening Practices and Risk Stratification for Diabetic Foot Complications in Primary Healthcare Clinics: A Cross-Sectional Study in Gauteng Province, South Africa
Summary: This cross-sectional study in Gauteng, South Africa, involved 597 diabetic patients at five primary healthcare centers. Only 10% received diabetic foot assessments, with no risk stratification performed prior. Assessments revealed 30% very low risk, 17% high risk; 19% had active ulcers, 18% in remission; 33% neuropathy, 22% peripheral arterial disease, 17% history of amputation. Risk factors included multimorbidity (p=0.021), poor glycemic control (p=0.003), loss of sensation (p=0.017), and absent pulses (p=0.037). Barriers: inadequate protocols, limited training, high workloads. Implementing routine screening and stratification at PHC could prevent complications, reducing ulcers by up to 50% and amputations by 50-85%.
Key Highlights:
- Prevalence: 19% active DFUs; 18% in remission; 33% neuropathy; 22% PAD; 17% amputation history.
- Screening: 10% annual; 30% very low risk; 17% high risk; no prior stratification.
- Risk: Multimorbidity (p=0.021); poor glycemic control (p=0.003); loss of sensation (p=0.017); absent pulses (p=0.037).
- Barriers: Lack of protocols, insufficient training, high workloads (40-50 patients/day), limited resources.
- Authors: Ntuli S et al.
Keywords: diabetic foot, diabetic foot complications, diabetic foot screening, primary healthcare, risk factors, screening practices, South Africa