Research

Chronic diseases are not being managed effectively in either high-risk or low-risk populations in South Africa

Martin Brand, Angela J Woodiwiss, Frederic Michel, Hendrik L Booysens, Olebogeng H I Majane, Muzi J Maseko, Martin G Veller, Gavin R Norton

Abstract


Background. Primary healthcare is the foundation of a country’s healthcare system. Without an efficient and cost-effective programme, the level of healthcare offered across all levels of health management is adversely affected.

Objective. To analyse the effectiveness of the management of hypertension and diabetes mellitus (DM) among two distinct patient populations, one with significant cardiovascular risk factors and the other without.

Method. We performed a case control study of a high-risk group of patients presenting with chronic critical limb ischaemia (CLI) to the Divisions of Vascular Surgery at Charlotte Maxeke Johannesburg Academic Hospital and Chris Hani Baragwanath Academic Hospital, and a randomly selected group of ‘healthy’ community participants from Johannesburg’s South Western Townships (Soweto).

Results. We assessed 217 patients with CLI and 1 030 participants from the community. We assessed the number of patients who were not achieving their therapeuatic targets, among those known to be hypertensive (CLI: 44.7%; community: 59.9%) and diabetic (CLI: 83.5%; community: 66%). Undiagnosed diabetes affected 10.8% of patients with CLI and 11% of the community sample.

Conclusion. Traditional vascular risk factors are managed poorly at both primary healthcare and at tertiary care levels. There is a need to identify factors that will address this issue. 


Authors' affiliations

Martin Brand, Department of Surgery, School of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Angela J Woodiwiss, Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Frederic Michel, Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Hendrik L Booysens, Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Olebogeng H I Majane, Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Muzi J Maseko, Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Martin G Veller, Department of Surgery, School of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Gavin R Norton, Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

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Keywords

hypertension; diabetes mellitus; chronic critical limb ischaemia; HIV

Cite this article

South African Medical Journal 2013;103(12):938-941. DOI:10.7196/SAMJ.6018

Article History

Date submitted: 2012-05-28
Date published: 2013-07-29

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