Factors associated with unacceptable knowledge, attitudes and practices of patients with type 2 diabetes on cardiovascular risk factors and diabetes-related complications in two health facilities of the West Region of Cameroon during the COVID-19 pandemic: a cross-sectional study

OBJECTIVE: To assess the level of knowledge, attitudes and practices (KAP) among patients with type 2 diabetes mellitus (T2DM) regarding cardiovascular risk factors (CVRF) and diabetes-related complications in two hospitals in the West Region of Cameroon during the COVID-19 pandemic. DESIGN: This was a prospective cross-sectional study conducted over 5 months from April to September 2022. SETTING: This study was conducted in two tertiary hospitals in the West Region of Cameroon, in Central Africa. PARTICIPANTS: It included all patients with T2DM receiving care at these two hospitals, having agreed to participate and followed up in both hospitals for at least 3 months. PRIMARY AND SECONDARY OUTCOME MEASURES: Sociodemographic, clinical and treatment data were collected using a data sheet, and KAP scores were based on the Essi and Njoya framework. Data collection and analysis were performed using SPSS V.23.0 software. Logistic regression was used to identify the factors associated with unacceptable KAP (p<0.05). RESULTS: A total of 140 participants (71 women) with an average age of 63 years and an average diabetes duration of 6.14±5.7 years were included. Most (55%) were managed by general practitioners. The main CVRFs identified were hypertension (11%) and overweight (6%), while the leading complications included visual disorders (10.7%), hypoglycaemia (6.4%) and erectile dysfunction (2.1%). Knowledge was good in 34.3% of participants, only 25.7% demonstrated correct attitudes, and merely 15.7% engaged in adequate practices. Unacceptable knowledge was associated with diabetes duration between 3 months and 5 years (OR: 0.34 (95% CI 0.14 to 0.85), p=0.021), follow-up by a specialist (OR: 0.31 (95% CI 0.13 to 0.74), p=0.009), the presence of at least one CVRF (OR: 0.03 (95% CI 0.00 to 0.23), p<0.001), and the presence of diabetes complications (OR: 0.26 (95% CI 0.09 to 0.78), p=0.016). No significant association was observed for unacceptable attitudes. Low economic status (OR: 3.7 (95% CI 1.55 to 8.82), p=0.003) was associated with unacceptable practices. CONCLUSION: Few people with T2DM presented good knowledge, right attitudes and adequate practices. Enhanced patient education and increasing specialist numbers are essential to promote self-management of the condition and to decrease the incidence of complications and mortality.