Patterns of Paediatric Orthopaedic Pathology in Zambian Children Seen at te UTH,ZIOH and The FLYSPEC Project
Date
2011-11-04
Authors
Makasa, Emmanuel Malabo
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Abstract
Musculoskeletal conditions are a common cause of long-term pain and physical disability affecting many people worldwide. Additionally, these conditions have an enormous economic and social impact on the individual, society and national health systems. Although the burden of disease due to musculoskeletal conditions is said to be on the rise in the developing world, the full extent of this burden remains unknown.
Objectives: To describe the patterns of musculoskeletal conditions seen in Zambian children aged less than 15 years and to asses limitations of access to orthopaedic services by estimating timing from onset to presentation and distance covered. The type of initial care at site of presentation will also be determined.
Methods: This was a hospital-based cross-sectional study done between April 2005 and May 2006. Relevant data on patient demographics, presenting musculoskeletal condition and treatment received was collected from medical records of 1246 patients at the University Teaching Hospital (UTH), Zambian-Italian Orthopaedic Hospital (ZIOH) and the Flying-Specialist (FLYSPEC) nationwide orthopaedic outreach. Included were patients aged less than 15 years who had a history being attended to by orthopaedic surgeons for a musculoskeletal condition. Those aged fifteen and above and those not attended to by orthopaedic surgeons despite them being aged less than fifteen and having a musculoskeletal condition were excluded from the study. Also excluded from analysis were patients that had two thirds of the key data missing from their medical record. From spreadsheets the data was imported into SPSS for analysis.
Results: Congenital abnormalities, other non-congenital deformities, and traumatic conditions were the most common pathology affecting the 1246 sampled children with prevalence rates of 0.49, 0.22 and 0.14 respectively. More males 762(61.2%) than females 484 (38.8%) had these conditions. Most patients 955 (76.6%) presented late at more than 3months from the onset of their condition with 509 (42.2%) having travelled for more than 10 kilometres to get to their treatment sites. 561 (45.4%) had been treated conservatively prior to their presentation to orthopaedics with another 471 (38.1%) having no record of having received any specific treatment.
Conclusion: Congenital abnormalities, non-congenital limb deformities and traumatic conditions were the most common musculoskeletal disorders. More males than females were afflicted. Most of these patients presented late to care and distance to health facility was strongly correlated to late presentation. Furthermore, at first presentation majority of these children received conservative or no specific treatment from the first-line health workers at local health centres.
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Keywords
Pediatric Orthopaedics--Zambia , Children-Surgery orthopedics--Zambia