Diabetic foot self-care practices and its predictors among diabetes mellitus patients in Ethiopia: systematic review and meta-analysis

Objective The study aims to identify self-care practices related to diabetic foot care and determine their predictors among diabetes mellitus (DM) patients in Ethiopia.Design Systematic review and meta-analysis.Data sources Data were collected from PubMed/MEDLINE, ScienceDirect, Google Scholar and g...

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Main Authors: Sefineh Fenta Feleke, Zelalem Dejazmach, Abebe Merchaw Faris, Tesfaye Engidaw Habtie, Adugnaw Atnafu Atalay, Natnael Amare Tesfa, Getachew Derbew
Format: Article
Language:English
Published: BMJ Publishing Group 2025-03-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/3/e092626.full
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author Sefineh Fenta Feleke
Zelalem Dejazmach
Abebe Merchaw Faris
Tesfaye Engidaw Habtie
Adugnaw Atnafu Atalay
Natnael Amare Tesfa
Getachew Derbew
author_facet Sefineh Fenta Feleke
Zelalem Dejazmach
Abebe Merchaw Faris
Tesfaye Engidaw Habtie
Adugnaw Atnafu Atalay
Natnael Amare Tesfa
Getachew Derbew
author_sort Sefineh Fenta Feleke
collection DOAJ
description Objective The study aims to identify self-care practices related to diabetic foot care and determine their predictors among diabetes mellitus (DM) patients in Ethiopia.Design Systematic review and meta-analysis.Data sources Data were collected from PubMed/MEDLINE, ScienceDirect, Google Scholar and grey literature sources. Databases were searched from inception to August 2024.Eligibility criteria Observational studies (including cross-sectional, case–control, cohort and survey designs) reporting diabetic foot self-care practices and their predictors among DM patients in Ethiopia. Our inclusion criteria encompassed articles published in English, and we considered studies conducted in both healthcare institutions and community settings.Data extraction and synthesis Microsoft Excel was used for data extraction and summary, while the analysis was performed with R software V.4.3.2. The overall pooled prevalence of diabetic foot self-care practices and their predictors were estimated using a random-effects model. Publication bias was assessed both graphically, using funnel plots, and statistically, with tests such as Egger’s regression test. The reviewers systematically assessed potential bias in individual studies using the Newcastle–Ottawa Quality Assessment Scale, and the certainty of evidence was assessed by Grade of Recommendations Assessment, Development and Evaluation (GRADE). Subgroup analysis was carried out to minimise random variations in the estimates from the primary studies.Results The pooled prevalence of good diabetic foot self-care practice in Ethiopia was 51% (95% CI: 41% to 61%; I²=98%, p≤0.001). Factors associated with diabetic foot self-care practices among diabetic patients included knowledge of foot care (adjusted OR (AOR)=2.42; 95% CI: 1.20, 3.62), being female (AOR=1.23; 95% CI: 1.02, 1.98) and rural residency (AOR=1.23; 95% CI: 1.02, 1.98). Both Egger’s test (p=0.4430) and Begg’s test (p=0.501) indicated no significant evidence of publication bias. Regarding the certainty of evidence, the overall GRADE rating is categorised as low.Conclusions The overall prevalence of good diabetic foot self-care practices among DM patients in Ethiopia is relatively high. Residence, sex and knowledge of foot care were identified as key predictors of effective foot self-care practices in this population. To enhance diabetic foot self-care in Ethiopia, it is crucial to strengthen education on foot care. Tailored interventions should be developed specifically for men and rural residents to improve their diabetic foot self-care practices.
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spelling doaj-art-56be3c7aa4be4fae853cdfab05f042022025-08-20T02:54:23ZengBMJ Publishing GroupBMJ Open2044-60552025-03-0115310.1136/bmjopen-2024-092626Diabetic foot self-care practices and its predictors among diabetes mellitus patients in Ethiopia: systematic review and meta-analysisSefineh Fenta Feleke0Zelalem Dejazmach1Abebe Merchaw Faris2Tesfaye Engidaw Habtie3Adugnaw Atnafu Atalay4Natnael Amare Tesfa5Getachew Derbew6Public Health, Woldia University, Woldia, EthiopiaDepartment of Medeical Laboratory Sciences, College of Health Sciences, Woldia University, Woldia, Ethiopia2 Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia2 Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia3 School of Medicine, College of Health Sciences, Woldia University, Woldia, Ethiopia3 School of Medicine, College of Health Sciences, Woldia University, Woldia, Ethiopia1 Department of Public Health, College of Health Science, Woldia University, Woldia, EthiopiaObjective The study aims to identify self-care practices related to diabetic foot care and determine their predictors among diabetes mellitus (DM) patients in Ethiopia.Design Systematic review and meta-analysis.Data sources Data were collected from PubMed/MEDLINE, ScienceDirect, Google Scholar and grey literature sources. Databases were searched from inception to August 2024.Eligibility criteria Observational studies (including cross-sectional, case–control, cohort and survey designs) reporting diabetic foot self-care practices and their predictors among DM patients in Ethiopia. Our inclusion criteria encompassed articles published in English, and we considered studies conducted in both healthcare institutions and community settings.Data extraction and synthesis Microsoft Excel was used for data extraction and summary, while the analysis was performed with R software V.4.3.2. The overall pooled prevalence of diabetic foot self-care practices and their predictors were estimated using a random-effects model. Publication bias was assessed both graphically, using funnel plots, and statistically, with tests such as Egger’s regression test. The reviewers systematically assessed potential bias in individual studies using the Newcastle–Ottawa Quality Assessment Scale, and the certainty of evidence was assessed by Grade of Recommendations Assessment, Development and Evaluation (GRADE). Subgroup analysis was carried out to minimise random variations in the estimates from the primary studies.Results The pooled prevalence of good diabetic foot self-care practice in Ethiopia was 51% (95% CI: 41% to 61%; I²=98%, p≤0.001). Factors associated with diabetic foot self-care practices among diabetic patients included knowledge of foot care (adjusted OR (AOR)=2.42; 95% CI: 1.20, 3.62), being female (AOR=1.23; 95% CI: 1.02, 1.98) and rural residency (AOR=1.23; 95% CI: 1.02, 1.98). Both Egger’s test (p=0.4430) and Begg’s test (p=0.501) indicated no significant evidence of publication bias. Regarding the certainty of evidence, the overall GRADE rating is categorised as low.Conclusions The overall prevalence of good diabetic foot self-care practices among DM patients in Ethiopia is relatively high. Residence, sex and knowledge of foot care were identified as key predictors of effective foot self-care practices in this population. To enhance diabetic foot self-care in Ethiopia, it is crucial to strengthen education on foot care. Tailored interventions should be developed specifically for men and rural residents to improve their diabetic foot self-care practices.https://bmjopen.bmj.com/content/15/3/e092626.full
spellingShingle Sefineh Fenta Feleke
Zelalem Dejazmach
Abebe Merchaw Faris
Tesfaye Engidaw Habtie
Adugnaw Atnafu Atalay
Natnael Amare Tesfa
Getachew Derbew
Diabetic foot self-care practices and its predictors among diabetes mellitus patients in Ethiopia: systematic review and meta-analysis
BMJ Open
title Diabetic foot self-care practices and its predictors among diabetes mellitus patients in Ethiopia: systematic review and meta-analysis
title_full Diabetic foot self-care practices and its predictors among diabetes mellitus patients in Ethiopia: systematic review and meta-analysis
title_fullStr Diabetic foot self-care practices and its predictors among diabetes mellitus patients in Ethiopia: systematic review and meta-analysis
title_full_unstemmed Diabetic foot self-care practices and its predictors among diabetes mellitus patients in Ethiopia: systematic review and meta-analysis
title_short Diabetic foot self-care practices and its predictors among diabetes mellitus patients in Ethiopia: systematic review and meta-analysis
title_sort diabetic foot self care practices and its predictors among diabetes mellitus patients in ethiopia systematic review and meta analysis
url https://bmjopen.bmj.com/content/15/3/e092626.full
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