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Original Research
Prevalence of disease complications and risk factor monitoring amongst diabetes and hypertension patients attending chronic disease management programmes in a South African Township
Submitted: 07 April 2021 | Published: 08 September 2021
About the author(s)
Tiny Masupe, Department of Family Medicine and Public Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana; and, School of Public Health, Faculty of Health Sciences, University of the Western Cape, Bellville, Cape Town, South AfricaJeroen De Man, Department of Family Medicine and Population Health, Centre for General Practice, University of Antwerp, Antwerp, Belgium
Sunday Onagbiye, The Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potcheftroom Campus, South Africa
Thandi Puoane, School of Public Health, Faculty of Health Sciences, University of the Western Cape, Bellville, Cape Town, South Africa
Peter Delobelle, School of Public Health, Faculty of Health Sciences, University of the Western Cape, Bellville, Cape Town, South Africa; and, Chronic Disease Initiative for Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; and, Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
Abstract
Background: South Africa established chronic disease management programmes (CDMPs) called ‘clubs’ to ensure quality diabetes care. However, the effectiveness of these clubs remains unclear in terms of disease risk factor monitoring and complication prevention.
Aim: We assessed risk factor monitoring, prevalence and determinants of diabetes related complications amongst type-2 diabetes (T2D) and hypertension (HTN) patients attending two CDMPs.
Setting: Urban Township in Cape Town, South Africa.
Methods: Cross-sectional survey combined with a 10-year retrospective medical records analysis of adult T2D/HTN patients attending two CDMPs, using a structured survey questionnaire and an audit tool. Statistical Software for Social Sciences (SPSS) version 25 was used to analyse risk factor monitoring and calculate prevalence of complications. Potential determinants of complications were explored through logistic regression.
Results: There were 379 patients in the survey, 372 (97.9%) had HTN whilst 159 (41.9%) had T2D and HTN; 361 medical records were reviewed. Blood pressure (87.7%) and weight (86.6%) were the best monitored risk factors. Foot care (0.0% – 3.9%) and eye screening (0.0% – 1.1%) were least monitored. Nearly 22.0% of patients reported one complication, whilst 9.2% reported ≥ 3 complications. Medically recorded complications ranged from 11.1% (1 complication) to 4.2% with ≥ 3 complications. The most common self-reported and medically recorded complications were eye problems (33%) and peripheral neuropathy (16.4%), respectively. Complication occurrence was positively associated with age and female gender and negatively associated with perceived illness control.
Conclusions: Type-2 diabetes and hypertension patients experienced diabetes related complications and inadequate risk factor monitoring despite attending CDMPs. Increased self-management support is recommended to reduce complication occurrence.
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