The outcome of using the 60-second diabetic foot screen to identify the diabetic foot at risk in Tanzania

Abstract

Objective: To determine the pattern of risk for the development of diabetic foot complications in Tanzania. Setting: Diabetic care is offered in all public hospitals in Tanzania. Over 100 000 documented patients receive free or subsidised services. This is a small portion of the estimated one million patients with diabetes countrywide. Often, the clinics are congested and lack structured protocols for the focused screening of conditions and for risks that have the potential to cause diabetic foot. Subjects: Fifty patients were recruited from the diabetic clinic of Temeke Municipal Hospital. The 60-second diabetic foot screen was used for the diabetic foot risk assessment. Outcome measures: Risks factors that can cause diabetic foot and other foot complications were assessed. Results: It was determined that 10% of the studied population had a significant neuropathy. Other identified risk factors in this group of investigated diabetic feet were fissures (37%), calluses (27%), active ulcers (8%), fungi in toe-web spaces (27%), a previous history of foot ulcers (8%), ingrown toe nails (6%), blisters (4%), Charcot foot deformities (4%) and hammer toe lesions (2%). In this study, approximately 46% of the patients with diabetes wore inappropriate footwear upon presentation to the clinic. Conclusion: Patients with diabetes in Tanzania had risk factors that are associated with the development of diabetic foot complications. A screening tool, such as the adapted 60-second diabetic foot screen, may be used to facilitate a structured protocol for assessing the feet of patients with diabetes in busy Tanzanian clinics.