Atalay Yibeltal Assefa, Alemie Bersufekad Wubie, Gelaw Kelemu Abebe
School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
Department of Ophthalmology and Optometry, Hawassa University College of Medicine and Health Science, Hawassa, Ethiopia.
Front Endocrinol (Lausanne). 2025 Jun 4;16:1527402. doi: 10.3389/fendo.2025.1527402. eCollection 2025.
Nowadays, diabetes mellitus is a major global health issue with serious social, economic, and developmental impacts. One of its most severe complications is foot problems. Research shows that poor self-care practices in managing diabetic feet are a key factor in ulcer development.
This study aimed to determine the pooled prevalence of foot self-care practice and associated factors among diabetic patients in Africa.
We found articles using electronic databases, including PubMed, Cochrane Library, Google Scholar, Web of Science, African Journals Online, and Science Direct. Accordingly, we identified 143 published articles. A total of 31 eligible studies were included in the systematic review. Data extraction used a standardized checklist, and analysis was conducted with STATA 14 statistical software. Various methods were used to assess the presence of publication bias, including funnel plots and the Begg and Egger regression test. A significance level of P ≤0.05 was used to indicate potential publication bias. Heterogeneity between included studies was assessed using the I2 statistics. The random effect model was used to estimate the pooled estimates.
The pooled prevalence of foot self-care practices among diabetic patients in Africa was 46.93% (95%CI (39.44-54.41)). Diabetic foot self-care practices were significantly associated with rural residence (AOR: 2.50, 95% CI (1.65-3.80)), educational level (AOR: 3.00, 95%CI (2.07-4.34)), and knowledge level of diabetes patients (AOR: 3.41, 95%CI (2.22-5.23)).
In conclusion, more than half of diabetic patients had poor diabetes foot self-care practices. Diabetic foot self-care practice was associated with a level of education, rural residence, and the knowledge level of diabetic foot care. Therefore, intervention programs ought to prioritize enhancing the knowledge base of individuals with diabetes to promote better self-care practices for their feet.
如今，糖尿病是一个重大的全球健康问题，具有严重的社会、经济和发展影响。其最严重的并发症之一是足部问题。研究表明，糖尿病足管理中自我护理措施不佳是溃疡形成的关键因素。
本研究旨在确定非洲糖尿病患者足部自我护理措施的合并患病率及相关因素。
我们通过电子数据库查找文章，包括PubMed、Cochrane图书馆、谷歌学术、科学网、非洲在线期刊和科学Direct。据此，我们确定了143篇已发表的文章。共有31项符合条件的研究纳入系统评价。数据提取使用标准化清单，并使用STATA 14统计软件进行分析。采用多种方法评估发表偏倚的存在，包括漏斗图和Begg及Egger回归检验。P≤0.05的显著性水平用于表明潜在的发表偏倚。使用I2统计量评估纳入研究之间的异质性。采用随机效应模型估计合并估计值。
非洲糖尿病患者足部自我护理措施的合并患病率为46.93%（95%可信区间（39.44 - 54.41））。糖尿病足自我护理措施与农村居住情况（优势比：2.50，95%可信区间（1.65 - 3.80））、教育水平（优势比：3.00，95%可信区间（2.07 - 4.34））以及糖尿病患者的知识水平（优势比：3.41，95%可信区间（2.22 - 5.23））显著相关。
总之，超过一半的糖尿病患者糖尿病足自我护理措施不佳。糖尿病足自我护理措施与教育水平、农村居住情况以及糖尿病足护理知识水平相关。因此，干预项目应优先加强糖尿病患者的知识基础，以促进更好的足部自我护理措施。
