Department of Physiotherapy, College of Medicine and Health Sciences & Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
PLoS One. 2020 Aug 25;15(8):e0238001. doi: 10.1371/journal.pone.0238001. eCollection 2020.
The Foot health of a child plays a pivotal role in their participation in play, locomotive activities, healthy lifestyle, somatic development, and weight management. The burden of flatfoot among children in Ethiopia is not known. The objective of this study was to analyze the structure of the medial foot arch using Staheli plantar arch index and investigate its associated factors among larger sample school children, aged 11-15 years in Ethiopia.
A school-based cross-sectional study was conducted among children aged 11-15 years from eleven randomly selected primary schools. The sample size was determined proportionally across school strength and governmental and private schools to ensure variety within the sample. Data collection consisted of physical measurements, footprint-based measures whilst full weight-bearing, and a structured questionnaire on foot pain, footwear type, and physical activity. Data were analyzed descriptively and through uni- and multivariate logistic regression model.
A total of 823 children participated. The overall prevalence of flatfoot was 17.6% with a significant difference between age, gender, type of school, BMI, and type of footwear. Being younger (OR 3.3, 95% CI 1.6-6.7), male (OR 1.6, 95% CI 1.0-2.4), experiencing foot pain (OR 1.9, 95% CI 1.0-3.5), wearing closed shoe (OR 4.4, 95% CI 1.6-11.9), overweight (OR 3.8, 95% CI 1.2-8.7), obese (OR 4.2, 95% CI 2.5-10.9), and low level of physical activity (OR 2.1, 95% CI 1.0-4.6) were significantly associated with flatfoot. Children who were overweight, obese, and also experiencing foot pain have a 2.8 (95% CI 1.62-5.94) and 4.1 (95% CI 2.85-8.31) times greater chance of having flatfoot respectively. The prevalence of flatfoot among 560 normal weight children was 17.5%.
The findings of this study demonstrated that the overall prevalence and the prevalence of flatfoot among normal-weight children are almost the same. There is a definite need to develop a screening algorithm for diagnosis and treatment indication for this children's lower extremity disorder.
儿童足部健康对其参与游戏、运动活动、健康生活方式、身体发育和体重管理至关重要。然而，目前尚不清楚埃塞俄比亚儿童扁平足的患病负担。本研究旨在使用 Staheli 足底弓指数分析较大样本中 11-15 岁儿童的内侧足弓结构，并调查其相关因素。
采用整群随机抽样的方法，选取 11 所小学的 11-15 岁儿童进行横断面研究。根据学校规模、公立和私立学校进行比例抽样，以确保样本的多样性。数据收集包括身体测量、足迹测量和足底承重时的结构问卷，内容包括足痛、鞋类类型和体育活动。数据采用描述性和单变量及多变量逻辑回归模型进行分析。
共 823 名儿童参与研究。扁平足的总患病率为 17.6%，在年龄、性别、学校类型、BMI 和鞋类类型方面存在显著差异。年龄较小（OR 3.3，95%CI 1.6-6.7）、男性（OR 1.6，95%CI 1.0-2.4）、有足痛（OR 1.9，95%CI 1.0-3.5）、穿封闭鞋（OR 4.4，95%CI 1.6-11.9）、超重（OR 3.8，95%CI 1.2-8.7）、肥胖（OR 4.2，95%CI 2.5-10.9）和低水平体育活动（OR 2.1，95%CI 1.0-4.6）与扁平足显著相关。超重和肥胖且有足痛的儿童发生扁平足的风险分别增加 2.8 倍（95%CI 1.62-5.94）和 4.1 倍（95%CI 2.85-8.31）。560 名正常体重儿童中扁平足的患病率为 17.5%。
本研究结果表明，总体患病率和正常体重儿童的扁平足患病率几乎相同。因此，非常有必要制定一种儿童下肢疾病的筛查算法来进行诊断和治疗。
