Sustainable prevention of foot ulceration secondary to diabetic and leprotic neuropathy in Nepal

Diabetes and Leprosy can both lead to neuropathy, a complication that results in a loss of the protective pain sensation in the foot, an underlying cause of foot ulceration. The incidence of diabetes is rising exponentially in Nepal whilst Leprosy is still associated with significant stigma and discrimination leading to delays in seeking treatment and non-compliance. This project is funded by the Global Challenges Healthcare Fund. The project has two overarching aims. It firstly aims to undertake research to inform the design and evaluation of sustainable, cost effective footwear for people with diabetes and leprosy to prevent the onset of foot ulceration. Secondly, the project aims to build research capacity in Nepal through workshops to promote research methods and design and training and engaging Nepalese healthcare professionals to deliver the research arm of the study.

Research Aims:

The overall aim of this 4-phased project is to gain an increased understanding of the extent and impact of foot ulceration, secondary to diabetic and leprotic neuropathy, in Nepal, and to explore the effect of potential base shoe designs on plantar foot pressures.

Specific Objectives 

The specific objectives are:

1. To undertake an audit of in-patient and out-patient hospital notes of people with diabetes or leprosy to estimate

  • the incidence of diabetic and leprotic foot ulcers and amputations.
  • the anatomical location and how this varies with patient characteristics.
  • the current management of ulcers and how this varies with geographical location in Nepal.
2. To measure using clinical tests the foot and ankle health of a sample of people with diabetes or leprosy and to compare the results to age and gender matched healthy controls.

3. To measure the effects of two different shoe bases on plantar pressures while walking, comparing people with diabetes and leprosy with healthy controls.

4. In people with diabetes and leprosy to explore

  • beliefs, views and experiences about living with a foot ulceration. In particular its impact, barriers and enablers to foot ulcer treatment adherence and management
  • views and preferences regarding shoe and orthotic design (cosmesis and functionality)

Key staff

<p>Foot Ulceration Research in Nepal Research - Nepalese woman</p>
<p>Foot Ulceration Research in Nepal Research - Dr Aban and family&nbsp;<br></p>
<p>Foot Ulceration Research in Nepal Research - Nepalese woman<br></p>

International Workshop | 14-15 September | Kathmandu, Nepal

We would like to invite practitioners from health sciences disciplines to participate in 'International Workshop in Research Methodology' to be held on 14-15 September 2019. The workshop is organised by the faulty of Health and Human Sciences from University of Plymouth with the generous support from Global Challenges Research Fund. The workshop features highly enlightening and interactive sessions to encourage the exchange of ideas across a wide range of disciplines in the field of Clinical Research. 

The workshop program is developed with your interests in mind and features locally driven research and special panel discussions. Attend the workshop to network with your peers, exchange expertise and experiences, and arm yourself with the latest information to tackle health related challenges through research. 

This course is now full and we will not be able to accept any more applications

Programme:

Time Day 1 Day 2
09.00 - 09.45 Breakfast and registration N/A
09.45 - 10.00 Welcome N/A
10.00 - 11.00 Posing the question Research in Nepal: Nepalese health research council
11.00 - 12.00 Reviewing the literature Running clinical trials: Governance issues
12.00 - 12.30 Break Break
12.30 - 13.30 Project Design Local driven research
13.30 - 14.30 Lunch Lunch
14.30 - 15.30 Qualitative methods Internationally driven research
15.30 - 16.00 Break Break
16.00 - 17.00 Quantitative methods Panel discussion: Barriers and facilitators to research
Evening Cultural event and meal (if sponsor) N/A

Course on the management of the diabetic foot and rehabilitation of peripheral neuropathy

12 September 2019,  Dhulikel Hospital, 9.30–17.00

In low to middle income countries the cost of amputation is cheaper than the cost of diabetic shoes. Treatment for a non healing ulcer can cost nearly six years wages.

Programme highlights

  • Epidemiology and pathology of diabetic foot ulcers.
  • Risk assessment frame module.
  • Off loading principles.
  • balance rehabilitation for peripheral neuropathy.
  • Management of diabetic foot ulcers (locally driven).
  • Research: sustainable prevention of foot ulceration secondary to diabetic and leprotic neuropathy in Nepal.


Who should attend?

Healthcare professionals responsible for managing people with diabetes including specialists, general practitioners, medical officers and nurses. 

Registration 

This course is now full and we will not be able to accept any more applications.

Job vacancies

Our partners in Nepal are recruiting a Research Assistant and Research Therapist to take part in the study 'Sustainable prevention of Foot Ulceration secondary to diabetic and leprotic neuropathy in Nepal'. The role runs for four weeks and will occur within the period 1 October 2019 until 31 January 2020. The exact dates of employment are subject to negotiation. Training will take place in Nepal on 10 September 2019.

Job profiles and application form

Please contact Dr Aban Gautam for an informal discussion or to apply.