Incidence of Diabetic Foot Ulcer among Diabetes Mellitus Patients Admitted to Nekemte Referral Hospital, Western Ethiopia: Prospective Observational Study

Background: Diabetic foot is defined as the foot of the diabetic patients with ulceration, infection, and/or distraction of the deep tissues associated with neurological abnormalities and varying degrees of peripheral vascular disease of the lower limb. Diabetic foot ulcers are a common and much feared complication of diabetes. The study is aimed to identify incidence of diabetic foot ulcer in diabetes patients of Nekemte Referral Hospital (NRH). Methods: A prospective observational study of diabetes mellitus patients who had diabetic foot ulcer was conducted from March15 to June 15, 2018.The data was entered into EPI-manager 4.0.2 software and analyzed using SPSS V.24. The Wagner classification of diabetic foot ulcer was used to assess the severity of foot ulcers. Size of ulcer was determined by multiplying the largest by the second largest diameter perpendicular to the first and the etiology of diabetic foot ulcer was identified by using gram stains. Results: Over the study period, 644 diabetes patients were admitted to the NRH medical service; of these, 115 (17.86%) had foot ulcers. About 61 (55.7%) were males and mean age of participants was 44.4 ± 14.7. After the gram stain was performed, about 77 (66.96%) of the patients with foot ulcer developed infection. From the diabetes mellitus who had developed diabetic foot ulcer, about 31 (26.96%) of ulcer were located on dorsal/interdigital toes. About 49 (42.61%) of the diabetic foot ulcer patients had previous history of ulcer of any location. Of infected diabetic foot ulcers, Forty two (54.55%) of microorganism isolated was gram positive. Conclusion: The incidence of diabetic foot ulcer among diabetic patients in Nekemte referral hospital was high. Therefore, East wollega zone health sector and Nekemtereferal hospital diabetic clinic diabetic care providers should strive to reduce its incidence through enhancing the regular diabetic foot evaluation.