Factors associated with severity and anatomical distribution of Diabetic Foot Ulcer in Uganda: A multicenter cross-sectional study
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Date
2022
Journal Title
Journal ISSN
Volume Title
Publisher
Research Square
Abstract
Diabetic foot ulcer (DFU) is a devastating complication of diabetes mellitus (DM)
associated with high mortality and morbidity including amputations of lower extremities; and a high
economic burden especially in low-income countries like Uganda. The aim of this study was to identify
the factors associated with severity of DFU and assess the anatomical distribution of DFU among
patients in Uganda.
Methodology: This was a multicenter cross-sectional study conducted in 7 selected referral hospitals in
Uganda. 117 patients with DM type 1 and 2 and foot ulcers were enrolled for this study from January to
March 2021. Using the Wagner classification, patients were categorized as less severe DFU (grade 1 and
grade 2) and severe DFU for grade 3 and above. A pre tested questionnaire was used to collect data. Data
were analyzed using STATA Version 14 with significance at 95% and p-value of <0.05.
Results: Out of 117 patients with DFU, 70 (59.8%) had severe DFU and 47 (40.2%) had less severe DFU.
Mean age in years was 57.5 (SD15.2) among all study participants in general. The right foot was
affected in (47.9%) of cases and the most frequent ulcer was found on the plantar of the foot (44.4%).
Majority of the patients had one ulcer (50.4%) and the most frequent ulcer size was >5 cm (47.9%).
Majority (61.5%) of the participants were female. Majority of participants, 90 (76.9%) also had
uncontrolled blood sugars and 27(29.1%) had normal glycemia
Severity of DFU was 3.4 more prevalent among patients with mild neuropathies (p=0.003), and 2.7 more
prevalent for those with moderate neuropathies (p=0.005). Also, severity of DFU was 1.5 more prevalent
in patients with an ulcer 5-10 cm of diameter (p=0.047) and 2.5 more prevalent in those with foot ulcer of
more than 10 cm of diameter (p=.000).
Conclusion:The study showed that most of the DFU patients have severe diabetic foot ulcer and
uncontrolled glycemia. Neuropathies and ulcers more than 5cm wide are precipitating factors to severity
of DFU and, therefore, early management is important to reduce the burden of the disease.
Description
Keywords
Diabetic foot ulcer, Severity
Citation
Vahwere, B. M., Ssebuufu, R., Namatovu, A., Kyamanywa, P., Ntulume, I., Mugwano, I., ... & Nasinyama, G. W. (2022). Factors associated with severity and anatomical distribution of Diabetic Foot Ulcer in Uganda: A multicenter cross-sectional study. https://doi.org/10.21203/rs.3.rs-2053553/v1