Анотація
Data on the epidemiology of paediatric osteomyelitis in sub-Saharan Africa is scarce. Children with chronic osteomyelitis (CO) were identified from a prospective paediatric surgery database at the main government referral hospital in Banjul, The Gambia. Hospital reported incidence of childhood osteomyelitis for Banjul and the Kanifing Municipal Area (two urban areas close to the hospital) was estimated from hospital records. From January 1996 - May 1998, 315 children aged 0 – 14 yrs were treated for CO accounting for 5.7% of paediatric surgical admissions and 15.4% of total paediatric surgical inpatient days. Eighty-five percent underwent sequestrectomy. The tibia (43%), femur (20%), and humerus (12%) were the commonest sites. Hospital reported incidence of paediatric chronic osteomyelitis in Banjul and the Kanifing Municipal Area (KMA) was 100 and 52 per 100,000 children, respectively. The incidence in Banjul is five times that reported for industrialized nations. CO is common in The Gambia and places a significant burden on the limited resources. Patients typically require sequestrectomy or debridement. While efforts at disease prevention include improving the general health of children in the region, early diagnosis and treatment is essential to reducing the burden of disease, the public and health professionals within each community need to be aware of the importance of early diagnosis and treatment of acute osteomyelitis which commonly preceeds the development of chronic osteomyelitis.
Keywords: Burden of disease, children, developing countries, incidence, chronic osteomyelitis, The
Gambia
Résumé
Les données épidémiologiques de l’ostéomyélite pédiatrique au sub-sahara Africain est rare. Les enfants ayant l’ostéomyélite chronique (OC) étaient identifiés dans une banque de données prospectives à l’hopital general de Banjul, en Gambie. L’hopital reportait l’incidence de l’ostéomyélite infantile à Banjul et dans la municipalité de Kanifing (deux zones urbaines proche de l’hôpital. Entre janvier 1996 – Mai 1998, 315 enfants âgés de 0-14 ans étaient traités pour l’ostéomyélite chronique s’estimant pour 5.7% des admissions en pédiatrie chirurgicale et 15.5% des chirurgies totales en pédiatrie. 85% ont eu de sequestrectomie. Le tibia (43%), fémur (20%), et humérus (12%) étaient les sites communs. Cette hôpital enregistrait une incidence d’ostéomyélite chronique a Banjul et la municipale de Kanifing de 100 et 52 pour 100,000 enfants, respectivement L’incidence a Banjul était cinq fois plus élevé que dans les nations industrialisées. L’ostéomyélite chronique est commune en Gambie et cause un problème significatif de sante publique. Bien que les efforts dans la prévention inclus l’amélioration de la sante général des enfants dans la région, le diagnostic précoce et traitement est essentiel dans la réduction de ce fléau, les personnels de sante dans cette communauté ont besoin d’être sensibiliser sur l’importance des soins précoces contre l’ostéomyélite.
Correspondence: Mr. Bade Omololu, FRCS, Department of Orthopaedics and Trauma, University College Hospital, Ibadan, Nigeria. E-mail: bade57@gmail.com
Посилання
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