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

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

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Funding

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

Author information

Authors and Affiliations

  1. Harvard Combined Orthopaedic Surgery Residency Program, Boston, MA, USA

    Kristin Alves

  2. Department of Orthopaedic Surgery, Brigham and Women’s Hospital, Boston, MA, USA

    Kristin Alves & Jeffrey N. Katz

  3. Department of Orthopaedic Surgery, University of British Columbia, Victoria, Canada

    Norgrove Penny

  4. Makerere University School of Public Health, Kampala, Uganda

    Olive Kobusingye

  5. Kumi Hospital, Kumi, Uganda

    Robert Olupot

  6. University of California San Francisco Department of Orthopaedic Surgery, UCSF Benioff Children’s Hospital Oakland, Oakland, CA, USA

    Coleen S. Sabatini

Authors
  1. Kristin Alves
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  2. Norgrove Penny
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  3. Olive Kobusingye
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  4. Robert Olupot
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  5. Jeffrey N. Katz
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  6. Coleen S. Sabatini
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Corresponding author

Correspondence to Coleen S. Sabatini.

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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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Alves, K., Penny, N., Kobusingye, O. et al. Paediatric musculoskeletal disease in Kumi District, Uganda: a cross-sectional survey. International Orthopaedics (SICOT) 42, 1967–1973 (2018). https://doi.org/10.1007/s00264-018-3915-x

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  • DOI: https://doi.org/10.1007/s00264-018-3915-x

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