Paediatric musculoskeletal disease in Kumi District, Uganda: a cross-sectional survey
- 72 Downloads
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.
KeywordsPediatric 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.
No informed consent required given this is a retrospective study.
- 6.Butler E, Tran T, Fuller A, Brammell A, Vissoci J, de Andrade L, Makumbi F, Luboga S, Muhumuza C, Ssennono V, Chipman J, Glaukande M, Haglund M, Smith E (2016) Quantifying the pediatric surgical need in Uganda: results of a national cross-sectional, household survey. Pediatr Surg Int 32:1075–1085CrossRefPubMedPubMedCentralGoogle Scholar
- 10.Uganda Bureau of Statistics (2014) National population and housing census (2014) http://www.ubos.org/onlinefiles/uploads/ubos/NPHC/2014%20National%20Census%20Main%20Report.pdf Accessed 23 May 2017
- 12.Ekure J (2016) Gluteal fibrosis. A report of 28 cases from Kumi Hospital, Uganda. East Central Afr J Surg 12:144–147Google Scholar
- 13.Sitati F, Naddumba E, Beyeza T (2010) Injection-induced sciatic nerve injury in Ugandan children. Trop Dr 40:223–224Google Scholar
- 15.Zhang X, Jiang X, He F, Liang Z, You T, Jin D, Zhang W (2016) Arthroscopic revision release of gluteal muscle contracture after failed primary open surgery. International Orthopaedics. 2016; published online Nov 2016Google Scholar
- 20.Country Statistics and Global Health Profile by WHO and UN partners (2015) Uganda http://www.who.int/gho/countries/uga.pdf?ua=1 Accessed 23 May 2017
- 23.World Health Organization (2009) WHO guidelines for safe surgery 2009: safe surgery saves lives. WHO, Geneva http://apps.who.int/iris/bitstream/10665/44185/1/978924159855_eng.pdf. Accessed 23 May 2017Google Scholar