Common causes of lower limb amputation in a rural community in South Africa

Aim: To determine the most common cause of lower limb amputation in a rural setting in South Africa.Methods: The study was set in the four district hospitals and one regional hospital in a rural health district in northern Kwa-Zulu Natal. A mixed methods approach was used to collect data, and the specific type of design that was applied in this study was a concurrent convergent design. Data was collected in three stages independently of one another (two quantitative and one qualitative stage), and the findings was triangulated in order to come to a conclusion. Stage one was a quantitative retrospective document analysis, stage two utilised a longitudinal prospective descriptive design and stage three consisted of semi-structured interviews with surgeons and amputees. Results: An average of 20 lower limb amputations were performed on a monthly basis in the regional hospital, and 71% of the people who lost their lower limbs were also diabetic. Of the diabetic population who lost lower limbs, 81% were also diagnosed with hypertension. Discussion/Conclusion: A relatively large number of lower limb amputations per month are performed at this rural regional hospital on a relatively young population. Contrary to what is reported in the literature relating to the common causes of lower limb amputation in a rural setting in developing countries, diabetes mellitus was identified as the leading cause of lower limb loss. This information can assist to inform health promotion and diabetes and amputation prevention strategies in rural settings.