Research Article
Volume 4 Issue 7 - 2020
The Diabetes Foot Ulceration Burden: A Look at 10 Years In-Hospital Treatment Outcome in a Nigerian Teaching Hospital in the Commercial City of Aba
Nkpozi MO1*, Eleweke N2, Okoronkwo NC3 and Unachukwu CN4
1Endocrinology, Diabetes and Metabolism Unit, Department of Internal Medicine, Abia State University Teaching Hospital, ABSUTH, Aba, Nigeria
2Department of Surgery, ABSUTH, Aba, Nigeria
3Department of Paediatrics, ABSUTH, Aba, Nigeria
4Department of Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
*Corresponding Author: Nkpozi MO, Consultant Physician/Endocrinologist, Department of Internal Medicine, Abia State University Teaching Hospital, ABSUTH, Aba, Nigeria.
Received: May 25, 2020; Published: June 25, 2020




Abstract

Diabetic foot ulcerations (DFU) are, often, indications for admissions in the medical wards. Published literature on outcome of DFU admissions in Aba, South east Nigeria is scanty The objective of this study, therefore, is to determine the treatment outcome of DFU managed in the medical wards of the Department of Internal Medicine, Abia State University Teaching Hospital (ABSUTH), Aba, South East, Nigeria. This was a 10-year retrospective descriptive study in which data about diabetic patients admitted for foot ulcers was extracted from the Admission/Discharge registers in the male and female medical wards of ABSUTH, Aba from May 1, 2007 to April 30, 2017. Relevant data obtained were analyzed using Statistical Package for Social Sciences (SPSS) version 20.0 software. A total of 1220 subjects were admitted because of DM related complications of which 220 (18.03%) were admitted on account of diabetic foot ulcers, made up of 130 (59%) males and 90 (41%) females. Mortality among the diabetic admissions with foot ulcers was 20% and the mean duration of hospitalization was 25.04 ± 23.10 days with most deaths occurring within the first week of hospitalization. The burden of diabetic foot ulcerations in Aba is significant. Mortality from DFU is high with a long and variable duration of hospitalization. Strengthening of the diabetes care services and supports is recommended to prevent diabetic foot ulcers and achieve favorable outcome.

Keywords: Aba; Diabetes Mellitus; Foot Ulcers; Medical Wards; Outcome; Nigerian Teaching Hospital

References

    li>Sogwi Eugene. “Diabetes in Sub-saharan Africans and Africans”. In: Wass JAH, Stewart PM, Amiel SA, Davies MJ, editors, Oxford textbook of Endocrinology and Diabetes. 2nd Oxford: Oxford University press (2011): 2095-2143.
  1. Chinenye S., et al. editors, Epidemiology of Diabetes Mellitus”. In: Clinical Practice Guidelines for Diabetes Management in Nigeria, 2nd Portharcourt: Diabetes Association of Nigeria (2013): 2-8.
  2. International Diabetes Federation (IDF); IDF diabetes atlas, 4th edition (2009).
  3. International Diabetes Federation (IDF); IDF diabetes atlas, 9th edition, Brussels, Belgium (2019).
  4. Zhang P., et al. “Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis”. Annals of Medicine 49 (2017): 106-116.
  5. Abbas ZG and Archibald LK. “Epidemiology of the diabetic foot in Africa”. Medical Science Monitor 11 (2005): RA262-RA270.
  6. Singh N., et al. “Preventing foot ulcers in patients with diabetes”. The Journal of the American Medical Association 293 (2005): 217-228.
  7. International Working Group on the Diabetic Foot. “Epidemiology of Diabetic Foot Infections in a Population Based Cohort”. Noordwij kerhout, The Netherlands (2003).
  8. Lavery LA., et al. “Diabetic foot syndrome: evaluating the prevalence and incidence of foot pathology in Mexican Americans and non-Hispanic whites from a diabetes disease management cohort”. Diabetes Care 26 (2003): 1435-1438.
  9. Boulton AJM., et al. “The global burden of diabetic foot disease”. Lancet 366 (2005): 1719-1724.
  10. Ogbera AO., et al. “An assessment of the disease burden of foot ulcers in patients with diabetes mellitus attending a teaching hospital in Lagos, Nigeria”. The International Journal of Lower Extremity Wounds 5 (2006): 244-249.
  11. Anumah FO., et al. “Management outcome of diabetic foot ulcers in a teaching hospital in Abuja, Nigeria”. Journal of Diabetes and Its Complications 9 (2017): 15-20.
  12. Edo AE., et al. “Risk factors, ulcer grade and management outcome of diabetic foot ulcers in a Tropical Tertiary Care Hospital”. Nigerian Medical Journal 54 (2013): 59-63.
  13. Nkpozi MO., et al. “Diabetic admissions in the medical wards of Abia state university teaching hospital, Aba, South east, Nigeria: A 10- year review”. International Journal of Community Research 1 (2020): 13-18.
  14. Adeloye D., et al. “Estimating the prevalence, hospitalisation and mortality from type 2 diabetes mellitus in Nigeria: a systematic review and metaanalysis”. BMJ Open 7 (2017): e015424.
  15. Ugwu E., et al. “Burden of diabetic foot ulcer in Nigeria: Current evidence from the multicentre evaluation of diabetic foot ulcer in Nigeria”. World Journal of Diabetes3 (2019): 200-211.
  16. Nkpozi MO., et al. “Pattern and outcome of medical admissions in a teaching hospital in the Southeast region of Nigeria”. IJMHS 3 (2020): 856-861.
  17. Unachukwu CN., et al. “Mortality among diabetes in-patients in Portharcourt, Nigeria”. African Journal of Endocrinology and Metabolism1 (2008): 1-5.
  18. Boulton AJM. “The diabetic foot: A major problem of the new millennium”. International Diabetes Monitor 13 (2001): 1-6.
  19. Boulton AJM. “The pathway to ulceration: A ethiopathogenesis”. In Boulton AJ, Connor H, Cavanagh PR (ed) The foot in diabetes”. John Wiley and Sons Ltd, Chichester, England (1997): 37-47.
  20. Unachukwu C., et al. “Peripheral Neuropathy and Macro-angiopathy in diabetics with foot ulcers in Portharcourt, Nigeria”. Nigerian Journal of Orthopaedics and Trauma2 (2004): 214-224.
  21. Bakker K., et al. “International Working Group on the Diabetic Foot. The 2015 IWGDF guidance documents on prevention and management of foot problems in diabetes: development of an evidence-based global consensus”. Diabetes/Metabolism Research and Reviews 1 (2016): 2-6.
  22. Anumah F. “Handbook on Diabetic Foot care for Nigeria”. Lux Terra Foundation (2017).
  23. Almobarak AO., et al. “Prevalence of diabetic foot ulceration and associated risk factors: an old and still major public health problem in Khartoum, Sudan?” Annals of Translational Medicine 5 (2017): 340.
  24. Chiwanga FS and Njelekela MA. “Diabetic foot: prevalence, knowledge, and foot self-care practices among diabetic patients in Dar es Salaam, Tanzania - a cross-sectional study”. Journal of Foot and Ankle Research 8 (2015): 20.
  25. Baba M., et al. “Temporal changes in the prevalence and associates of diabetes-related lower extremity amputations in patients with type 2 diabetes: the Fremantle Diabetes Study”. Cardiovascular Diabetology 14 (2015): 152.
  26. Stoekenbroek RM., et al. “How common are foot problems among individuals with diabetes? Diabetic foot ulcers in the Dutch population”. Diabetologia 60 (2017): 1271-1275.
  27. Al-Rubeaan K., et al. “Diabetic Foot Complications and Their Risk Factors from a Large Retrospective Cohort Study”. PLoS ONE 5 (2015): e0124446.
  28. Al-Mahroos F and Al-Roomi K. “Diabetic neuropathy, foot ulceration, peripheral vascular disease and potential risk factors among patients with diabetes in Bahrain: a nationwide primary care diabetes clinic based study”. Annals of Saudi Medicine 27 (2007): 25-31.
  29. Bruun C., et al. “Amputations and foot ulcers in patients newly diagnosed with type 2 diabetes mellitus and observed for 19 years. The role of age, gender and co-morbidity”. Diabetic Medicine 30 (2013): 964-972.
  30. Ekpebegh CO., et al. “Diabetes foot ulceration in a Nigerian hospital: in-hospital mortality in relation to the presenting demographic, clinical and laboratory features”. International Wound Journal 6 (2009): 381-385.
  31. Katsilambros N., et al. “Atlas of Diabetic Foot”. Chichester, UK: Wiley-Blackwell (2003).
  32. Shahi SK., et al. “Prevalence of Diabetic Foot Ulcer and Associated Risk Factors in Diabetic Patients From North India”. The Journal of Diabetic Foot Complications 4 (2012): 83-91.
  33. Centers for Disease Control and Prevention (CDC). “Diabetes Surveillance System”. Atlanta, GA, U.S.: Department of Health and Human Services (1993): 87-89.
  34. Moss SE., et al. “The prevalence and incidence of lower extremity amputation in a diabetic population”. Archives of Internal Medicine 152 (1992): 610-616.
  35. Thanni LO and Tade AO. “Extremity amputations in Nigeria - a review of indications and mortality”. Surgeon 4 (2007): 213-217.
  36. International Diabetes Federation. Diabetes atlas 8th International Diabetes Federation (2017).
Citation: Nkpozi MO., et al. “The Diabetes Foot Ulceration Burden: A Look at 10 Years In-Hospital Treatment Outcome in a Nigerian Teaching Hospital in the Commercial City of Aba". EC Diabetes and Metabolic Research 4.7 (2020): 01-08.

PubMed Indexed Article


EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005


EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777


EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347


EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478


EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253


EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033


EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992


EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505


EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793


EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211


EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047


EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560


EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318


EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819


EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840


EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344


EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476


EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658


EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489


EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278


EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108


EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571


EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333


EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883


EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001


EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937


EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723


EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726


EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603


EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646


EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616


EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290


EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226


EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812


EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268


News and Events


September Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the September issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before October 14, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.