Prevalence, Screening Practices and Risk Stratification for Diabetic Foot Complications in Primary Healthcare Clinics: A Cross-Sectional Study in Gauteng Province, South Africa

Background/Objective: The incidence of diabetic foot complications has been increasing in South Africa. While foot screening at the primary healthcare level is crucial for preventing these complications, the growing number of cases in hospitals indicates that patients with diabetes are not undergoing routine screening in primary healthcare settings. Method: This cross-sectional descriptive observational study was conducted at five community healthcare centres, one in each municipality in Gauteng. Participants included patients with diabetes who presented at these facilities for their routine diabetes care. Data were collected, which included patient demographics, a history of screening, risk factors for diabetic foot, and an assessment of diabetic foot was conducted for each participant. Results: A total of 597 diabetic patients volunteered for this study. Only 10% (n=60) had received a diabetic foot assessment. No patient had been risk-stratified; the results showed that 30% (n=178) were very low risk and 17% (101) were at high risk. Active ulcers were recorded in 19% (116), and 18% (106) were in remission. Neuropathy was recorded in 33% (1498), peripheral arterial disease in 22% (131), and a history of amputation was recorded in 17% (103). Conclusion: Implementing routine diabetic foot assessment and risk stratification at the PHC level could be key in preventing diabetic-related complications.