Wound infections and recovery time among patients with diabetic foot ulcer living in multiethnic Suriname, a developing country: a retrospective cohort study among patients from the One Stop Shop for chronic diseases Paramaribo
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The purpose of this study was to describe patient characteristics and clinical outcome among patients with diabetic foot ulcers under treatment of a multidisciplinary outpatient clinic in multiethnic Suriname, a developing country in South America. Retrospectively, all diabetes patients (> 18 years) with foot ulcers starting their treatment at the outpatient clinic between November 2013 and October 2014 were included and followed for at least 12 weeks. To assess differences in clinical outcome between subgroups, chi-square and incorporating time-related data, the log-rank test were used. One hundred patients were included (lost to follow-up, n = 20). Half of patients were males (n = 40). Mean age was 57.8 years. Nephropathy, peripheral arterial disease, and neuropathy were present in 90.9, 41.7, and 90.3%, respectively. Thirty-five percent of wounds healed within 12 weeks (median at 50 days, 13 visits). Sixty-eight percent of wounds were infected. No major but four minor amputations were carried out. Looking at subgroups, infection and ethnicity (African vs. Asian descent), but not gender or age, increased risk for delayed healing (p < 0.001 and p = 0.049, log-rank test). It seems of high priority to increase awareness and search for accurate preventive strategies for diabetic foot, and related wounds and infections, with special attention for ethnic disparities, in Suriname.
KeywordsDiabetic foot ulcer Infection Recovery Amputation Developing country Ethnic disparity
The authors thank Priscilla van Brussel, Shakieta Joerawan, Devika Soedamah, and Vern Nanhoe, medical students at the Faculty of Medical Sciences, Anton de Kom University Suriname, for their participation at the data collection and management.
LK coordinated this study together with ISK and LMN-vV. LMN-vV conducted statistical analysis, reviewed the data and results, and wrote the manuscript. CP and BA assisted in the data collection and statistical analyses. CP, BA, EB, ISK, and LK collaborated with the interpretation of data, and reviewed and edited the manuscript. All authors read and approved the final manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in this study involving human participants were in accordance with the ethical standards of the national research committee, the Ethics Committee of the Ministry of Health of Suriname, and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Because of the retrospective study design, informed consent was not obtained from the subjects. All data were gathered primarily for standard clinical care. To guaranty confidentiality, analyses were on group level and anonymized by coding.
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