Zulfiqarali G. Abbas|Lennox K. Archibald
Challenges for management of the diabetic foot in Africa: doing more with less
Muhimbili University of Health and Allied Sciences|University of Florida
diabetes mellitus reached epidemic proportions much lessdeveloped world decade ago africa incidence prevalence rates diabetes increasing foot complications rising parallel predominant risk factor foot complications underlying peripheral neuropathy although body evidence confirm increasing role peripheral vascular disease gangrene infections two serious sequelae diabetic foot ulcer disease cause longstanding disability loss income amputation death unfortunately diabetes imposes heavy burden health services many african countries resources already scarce cut back reasons poor outcomes foot complications various lessdeveloped countries include following lack awareness foot care issues among patients health care providers alike professionals interest diabetic foot trained provide specialist treatment non existent podiatry services long distances patients travel clinic delays among patients seeking timely medical care among untrained health care providers referring patients serious complications specialist opinion lack concept team approach absence training programs health care professionals finally lack surveillance activities ways improving diabetic foot disease outcomes require exorbitant outlay financial resources include implementation sustainable training programmes health care professionals focusing management complicated diabetic foot educational programmes include dissemination information health care professionals patients sustenance working environments inculcate commitment individual physicians nurses self growth rational optimal use existing microbiology facilities prescribing epidemiologically directed empiricism appropriate using sentinel hospitals surveillance activities allied golden rules prevention ie maintenance glycaemic control prevent peripheral neuropathy regular feet inspection making effort walk barefooted cut foot callosities razors knives home avoidance delays presenting hospital earliest onset foot lesion reductions occurrence adverse events associated diabetic foot feasible lessdeveloped settings