A rapid urbanisation and changes in lifestyle has caused changes in the disease burden in Nigeria. According to IDF the diabetes prevalence has reached 4.99 % which is roughly around 4 million living with diabetes. With 69 % of the population living under the poverty line and out of pocket health expenditure estimated to account for 69 % the consequences of the changed disease burden can be immense. Diabetes mellitus foot syndrome (DMF) is a major complication of DM in Nigerians with DM. The prevalence of DMF in Nigeria is 9 % and in Lagos, DMF accounts not only for 30 % of all DM related deaths but is also associated with a case fatality rate of 28 %. The amputation rates of DMF in Lagos are as high as 40 %. To reduce the disease burden of diabetes mellitus related foot ulcers in Lagos, Nigeria by engaging the use of preventative measures.
The project will be based on the step by step model. It is intended to facilitate easy access to foot care as well as build capacity for healthcare personnel involved in taking care of persons living with DM. Healthcare workers at the designated facilities (doctors, nurses and DM educators) will be educated on the care of the foot in persons living with DM. To create awareness on foot care to persons with DM and also to sensitise them on the risk factors for foot ulceration community visits will be conducted at traditional markets or a town hall of the community. Ten communities will be chosen for this purpose and screening for DM will be offered alongside routine counselling and referral to foot clinics. Foot camps will be held in small groups with practical demonstrations and screening of the participants’ feet. People identified with risk factors will be offered treatment and foot care kits. Foot camps will also be held for people attending the clinics and those found to have DM from the community screening exercise. These camps are expected to be held for about 100 persons from each centre. Focal persons will be chosen from each centre to ensure sustainability and continuation of awareness activities. Educational materials will be developed and distributed to patients at the screening camps and at the clinics. A team of persons from STRUHI, Diabetes Association of Nigeria and Diabetes Centre of Lagos State University Teaching Hospital will do advocacy visits to twenty selected health care facilities. The purpose of the visits will be to create awareness on DM and sensitize this cadre of staff on the importance of setting up a foot clinic in their facility. Health care professionals will also be trained on the essentials in offering a routine screening of the foot for people with DM. The overall goal is to do capacity building which will be based on the Step by Step model whereby there will be a basic course and advanced course. Foot care clinics will be set up and equipped at selected hospitals based on the prevalence of DM in the uptake area of the hospital to improve access to care for people with DM and foot ulcers. For the whole duration of the project information on the burden of foot ulcers, trends and care will be registered at STRUHI Centre to document and share the knowledge gain in the project.
• 21 clinics strengthened to provide diabetes foot care• 3,710 people screened for diabetes at screening camps• 9,560 patients (known and new) with diabetes screened for diabetic foot complications• 272 doctors, 163 nurses and 34 health educators trained on diabetes and diabetic foot care