International Orthopaedics

, Volume 42, Issue 8, pp 1967–1973 | Cite as

Paediatric musculoskeletal disease in Kumi District, Uganda: a cross-sectional survey

  • Kristin Alves
  • Norgrove Penny
  • Olive Kobusingye
  • Robert Olupot
  • Jeffrey N. Katz
  • Coleen S. SabatiniEmail author
Original Paper



The purpose of this study is to estimate the burden of musculoskeletal disease among children treated in Kumi District, Uganda, to inform training, capacity-building efforts, and resource allocation.


We conducted a retrospective cohort study by reviewing the musculoskeletal (MSK) clinic and community outreach logs for children (age < 18 years) seen at Kumi Hospital in Kumi, Uganda, between January 2013 and December 2015. For each patient, we recorded the age, sex, diagnosis, and treatment recommendation.


Of the 4852 children, the most common diagnoses were gluteal and quadriceps contractures (29.4% (95% CI 28.1–30.7%), 96% of which were gluteal fibrosis), post-injection paralysis (12.7% (95% CI 11.8–13.6%)), infection (10.5% (95% CI 9.7–11.4%)), trauma (6.9% (95% CI 6.2–7.6%)), cerebral palsy (6.9% (95% CI 6.2–7.7%)), and clubfoot (4.3% (95% CI 3.8–4.9%)). Gluteal fibrosis, musculoskeletal infections, and angular knee deformities create a large surgical burden with 88.1%, 59.1%, and 54.1% of patients seen with these diagnoses referred for surgery, respectively. Post-injection paralysis, clubfoot, and cerebral palsy were treated non-operatively in over 75% of cases.


While population-based estimates of disease burden and resource utilization are needed, this data offers insight into burden of musculoskeletal disease for this region of Sub-Saharan Africa. We estimate that 50% of the surgical conditions could be prevented with policy changes and education regarding injection practices and early care for traumatic injuries, clubfeet, and infection. This study highlights a need to increase capacity to care for specific musculoskeletal conditions, including gluteal fibrosis, post-injection paralysis, infection, and trauma in the paediatric population of Uganda.


Pediatric musculoskeletal health Pediatric orthopaedics Gluteal fibrosis Post-injection paralysis MSK burden Uganda 



This study received support from the NIH 5T32AR055885-08.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants

This article received IRB approval.

Informed consent

No informed consent required given this is a retrospective study.


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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  • Kristin Alves
    • 1
    • 2
  • Norgrove Penny
    • 3
  • Olive Kobusingye
    • 4
  • Robert Olupot
    • 5
  • Jeffrey N. Katz
    • 2
  • Coleen S. Sabatini
    • 6
    Email author
  1. 1.Harvard Combined Orthopaedic Surgery Residency ProgramBostonUSA
  2. 2.Department of Orthopaedic SurgeryBrigham and Women’s HospitalBostonUSA
  3. 3.Department of Orthopaedic SurgeryUniversity of British ColumbiaVictoriaCanada
  4. 4.Makerere University School of Public HealthKampalaUganda
  5. 5.Kumi HospitalKumiUganda
  6. 6.University of California San Francisco Department of Orthopaedic SurgeryUCSF Benioff Children’s Hospital OaklandOaklandUSA

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