Paediatric musculoskeletal disease in Kumi District, Uganda: a cross-sectional survey
Date
2018Author
Kristin, Alves
Norgrove, Penny
Olive, Kobusingye
Robert, Olupot
Jeffrey N., Katz
Coleen S., Sabatini
Metadata
Show full item recordAbstract
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.