Centre for Global Surgery, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town.
S Afr Fam Pract (2004). 2022 Apr 25;64(1):e1-e6. doi: 10.4102/safp.v64i1.5447.
There is a paucity of data on the coverage of diabetes mellitus (DM) complications screening in primary healthcare facilities in South Africa (SA). This study assesses the extent of screening for DM complications among individuals with type 2 DM attending primary health facilities in rural Eastern Cape (EC), SA.
The study adopted a descriptive, cross-sectional design and obtained data from 372 individuals with type 2 diabetes attending six selected primary healthcare centres (PHCs) in two EC districts. Demographic and clinical data were obtained through questionnaire-based interviews and reviews of medical records. We assessed the extent of screening for estimated glomerular filtration rate (eGFR), fasting lipogram, eye examination, foot examination and glycated hemoglobin (HbA1c) in the past year.
Participants mean age was 62 (standard deviation [s.d.] ± 11) years, and their mean duration of diagnosis was 9 (s.d. ± 8) years. In the past year, HbA1c result was available for 71 (19.1%) of the participants; 60 (16.1%) had eGFR results, while only 33 (8.9%) had documented lipid results. In total, 52 (14.0%) had carried out eye examinations, while only 9 (2.3%) had undergone foot examinations in the past year. About two-thirds of the participants (59.9%) had not undergone any form of complication screening in the past year, and none had undergone the complete screening panel.
The coverage of screening for DM complications was low across all indicators. Studies to understand barriers to and facilitators of DM complications screening at PHCs are required. Also, interventions to improve diabetes complication screening in the region are needed and should target the primary healthcare providers.
南非（SA）基层医疗设施中糖尿病（DM）并发症筛查的覆盖范围数据很少。本研究评估了在 SA 东开普省（EC）农村地区的基层卫生保健机构就诊的 2 型糖尿病患者中 DM 并发症筛查的程度。
本研究采用描述性、横断面设计，从六家选定的东开普省两个区的基层医疗中心（PHC）就诊的 372 名 2 型糖尿病患者中获得数据。通过问卷调查和病历回顾获得人口统计学和临床数据。我们评估了过去一年中估计肾小球滤过率（eGFR）、空腹血脂谱、眼部检查、足部检查和糖化血红蛋白（HbA1c）的筛查程度。
参与者的平均年龄为 62（标准差[SD]±11）岁，平均诊断时间为 9（SD±8）年。在过去一年中，71（19.1%）名参与者的 HbA1c 结果可用；60（16.1%）有 eGFR 结果，而只有 33（8.9%）有记录的血脂结果。总共有 52（14.0%）人进行了眼部检查，而只有 9（2.3%）人在过去一年中进行了足部检查。大约三分之二的参与者（59.9%）在过去一年中没有进行任何形式的并发症筛查，而且没有人进行过完整的筛查。
所有指标的 DM 并发症筛查覆盖率都很低。需要研究了解 PHC 中 DM 并发症筛查的障碍和促进因素。此外，还需要在该地区开展改善糖尿病并发症筛查的干预措施，应针对基层医疗服务提供者。
