The prevalence and incidence of diabetic foot ulcers among five countries in the Arab world: a systematic review

Mairghani, Maisoon; Elmusharaf, Khalifa; Patton, Declan; Burns, Jane; Eltahir, O; Jassim, Ghufran; Moore, Zena

doi:10.12968/jowc.2017.26.sup9.s27

Cited by 37 publications

(31 citation statements)

References 22 publications

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“…A systematic review in six Arab countries showed that the mean prevalence of DFU was 6% (15). Thus, the frequency of DFU in the current study was higher than the DFU prevalence in the world, Asia, and the Arab world (7,15). However, some studies in line with our study had reported a higher frequency of DFU.…”

Section: Discussionsupporting

confidence: 57%

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Frequency of Diabetes Foot Ulcer and Related Factors Among Adult Diabetic Patients in the Diabetes Center of Kerman, Iran

Khalooei

Meymand

2019

Shiraz E-Med J

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Background: Diabetic Foot Ulcer (DFU) as one of the main complications of diabetes mellitus has serious outcomes such as infection, foot amputation, low quality of life, and premature death. Objectives: This study was conducted to assess the DFU prevalence and its related factors among diabetic patients. Methods: The population of this cross-sectional study included adult diabetic patients in the Diabetes Center of Kerman University of Medical Sciences. The data were recorded in a questionnaire using patients' medical records, interviews with them, and physical examination. The collected data were imported to SPSS version 22 software and analyzed. Results: Of 400 diabetic patients enrolled in the study, 69% (n = 276) were female. The mean (± SD) of their age was 57.1 (± 11.9) years and 72% (n = 288) were younger than 65. The frequency of DFU during the total course of the disease and its annual prevalence were 17.3% (n = 69) and 11.8% (n = 49) among diabetic patients, respectively. More than one-third (37.7%) of the DFU patients and 6.6% of all the patients were admitted to a hospital due to DFU. Major or minor amputation was performed for 14.5% (n = 10) of the total DFU patients and 2.5% of the total patients. Having diabetes-related complications was determined as the strongest predictor of DFU (OR = 7.016, 95% CI = 2.67-18.38), followed by smoking (OR = 3. 80, 95% CI = 2.06-6.99) and age over 64 years (OR = 3.70, 95% CI = 1.299-10.568). Conclusions: The frequency of DFU was high among diabetic patients attending the Diabetes Center of Kerman University of Medical Sciences. Also, hospital admission and foot amputation due to DFU had a considerable frequency. Therefore, there is a crucial need to improve the quality of foot care services and emphasize foot self-care as essential components of diabetes self-management at all levels of the health service delivery system to decrease the risk of DFU.

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Section: Discussionsupporting

confidence: 57%

“…A meta-analysis in 2017 showed that the DFU prevalence is 6.3% in the world and 5.5% in Asia (7). A systematic review in six Arab countries showed that the mean prevalence of DFU was 6% (15). Thus, the frequency of DFU in the current study was higher than the DFU prevalence in the world, Asia, and the Arab world (7,15).…”

Section: Discussionmentioning

confidence: 47%

Frequency of Diabetes Foot Ulcer and Related Factors Among Adult Diabetic Patients in the Diabetes Center of Kerman, Iran

Khalooei

Meymand

2019

Shiraz E-Med J

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“…Mauro Rigato reported the characteristics of patients with diabetic foot in Africa, with great attention to prevalence, amputation, and mortality of ulcers . Mairghani M et al also performed a systematic review to reveal prevalence and incidence of diabetic foot ulcers in the Arab world . However, the recurrence of diabetic foot has been neglected.…”

Section: Introductionmentioning

confidence: 99%

“…16 Mairghani M et al also performed a systematic review to reveal prevalence and incidence of diabetic foot ulcers in the Arab world. 17 However, the recurrence of diabetic foot has been neglected. Although recurrence rates of diabetic foot ulcers have been described in several published studies, they varied widely in different studies, and the sample sizes of those studies were small.…”

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confidence: 99%

Global recurrence rates in diabetic foot ulcers: A systematic review and meta‐analysis

Ding

Miao

et al. 2019

Diabetes Metabolism Res

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Recurrence rates of diabetic foot ulcers vary widely in the published literature. The aim of this systematic review is to estimate recurrence rates of diabetic foot ulcers. We did a PubMed search and performed a review of reference lists for studies reporting recurrence of diabetic foot ulcers. The weighted relative risk (RR) and corresponding 95% confidence interval (CI) for recurrence was estimated. Forty‐nine studies reporting recurrence of diabetic foot ulcers were included. A pooled estimate for recurrence rate was 22.1% per person‐year (py) (95% CI, 19.0‐25.2%). Recurrence rate was 24.9% per py in Europe (95% CI, 20.0%‐29.7%), 17.8% per py in North America (95% CI, 12.7%‐22.9%), 16.9% per py in Africa (95% CI, 4.7%‐29.0%), and 17.0% per py in Asia (95% CI, 11.1%‐23.0%). Turkey had the highest recurrence rate of 44.4% per py (95% CI, 24.9%‐63.9%), and Bangladesh had the lowest of 4.3% per py (95% CI, 2.3%‐6.3%). Recurrence rates of diabetic foot ulcers before 2002, between 2002 and 2008, and after 2008 were 22.2% per py (95% CI, 17.6%‐26.8%), 21.9% per py (95% CI, 17.0%‐26.8%), and 21.8% per py (95% CI, 16.3%‐27.2%), respectively. Recurrence rates of diabetic foot ulcers are high. Recurrence rates vary widely in different regions and have decreased recently. More attention towards recurrence of diabetic foot ulcers is urgently required.

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“…However, only a few studies have investigated these DFU markers in Arab countries. A recent systematic review identified nine papers from five countries with varying DFU prevalence rates of between 2.7% in Iraq and 11.85% in Saudi Arabia [20]. One paper from Saudi Arabia reported an incidence rate of 1.8% [21].…”

Section: Introductionmentioning

confidence: 99%

Diabetic foot ulcer outcomes from a podiatry led tertiary service in Kuwait

Messenger

Masoetsa

Hussain

et al. 2018

Diabetic Foot & Ankle

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Objective: This single-centred study aims to evaluate the incidence, risk factors and treatment outcomes of a podiatry led, evidence-based diabetic foot ulcer (DFU) clinic. Research design and methods: Data from the DFU database and patient electronic health records were retrospectively collected from patients with new DFUs who were referred for treatment to the Department of Podiatry, Dasman Diabetes Institute, Kuwait, from 1 October 2014, to 31 December 2016. Patients were followed-up until healing occurred or until 6 months after the study end date, whichever came first. Results: All data were analysed using IBM SPSS version 24 software. Data were collected from 230 patients with 335 DFUs. Most DFUs (67%) were present for <3 months from the time of the first podiatry appointment. A total of 56% of DFUs were classified as neuropathic. Most (72%) DFUs healed, with a median healing time of 52.0 days. Chronic kidney disease (p = 0.001), retinopathy (p = 0.03), smoking (p = 0.02), ulcer location (p = 0.03), peripheral arterial disease (PAD) (p = 0.004) and osteomyelitis (p = 0.05) were found to have a meaningful association with DFU outcome. The number of days to heal was associated with ulcer classification (p = 0.005), bacterial infection (p = 0.002), osteomyelitis (p = < 0.001) and PAD (p = < 0.001). Conclusions: The incidence of new DFUs in our tertiary clinic is 3.4%. The incidence of diabetic foot ulceration, days to heal, healing rate and the risk factors influencing healing are in accordance with other multidisciplinary facilities with podiatry input.

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The prevalence and incidence of diabetic foot ulcers among five countries in the Arab world: a systematic review

Cited by 37 publications

References 22 publications

Frequency of Diabetes Foot Ulcer and Related Factors Among Adult Diabetic Patients in the Diabetes Center of Kerman, Iran

Frequency of Diabetes Foot Ulcer and Related Factors Among Adult Diabetic Patients in the Diabetes Center of Kerman, Iran

Global recurrence rates in diabetic foot ulcers: A systematic review and meta‐analysis

Diabetic foot ulcer outcomes from a podiatry led tertiary service in Kuwait

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