Royal London Hospital, Whitechapel Rd, Whitechapel, London, E1 1FR, UK.
Maidstone and Tunbridge Wells NHS Trust, Tonbridge Rd, Royal Tunbridge Wells, Tunbridge Wells, TN2 4QJ, UK.
BMC Musculoskelet Disord. 2021 Dec 21;22(1):1058. doi: 10.1186/s12891-021-04942-x.
Musculoskeletal impairment (MSI) in children is an under-recognised public health challenge. Although preventable, road injuries and other traumas continue to cause significant impairments to children worldwide. The study aimed to use the Key Informant Method (KIM) to assess prevalence and causes of MSI in children in two districts in Malawi, estimating the associated need for services provision, with a focus on traumatic aetiology.
The KIM was conducted in the districts of Thyolo (Southern Malawi) and Ntcheu (Central Malawi) in 2013. Five hundred key informants were trained to identify children who may have one of a range of MSI. The identified children were referred to a screening camp where they were examined by medical experts with standardised assessment protocols for diagnosing each form of impairment.
15,000 children were referred to screening camps. 7220 children were assessed (response rate 48%) for an impairment of whom 15.2% (1094) had an MSI. 13% of children developed MSI from trauma, while 54% had a neurological aetiology. For MSI of traumatic origin the most common body part affected was the elbow. Less than half of children with MSI (44.4%) were enrolled in school and none of these children attended schools with resources for disability. More than half of children with MSI (60%) had not received required services and 64% required further physical therapy.
The KIM method was used to identify a high prevalence of MSI among children in two districts of Malawi and estimates an unmet need for dedicated MSI services.
儿童肌肉骨骼损伤（MSI）是一个未被充分认识的公共卫生挑战。尽管可以预防，但道路伤害和其他创伤仍在全球范围内导致儿童严重损伤。本研究旨在使用关键知情人法（KIM）评估马拉维两个地区儿童的 MSI 患病率和病因，估计相关服务提供需求，重点关注创伤性病因。
KIM 于 2013 年在马拉维南部的 Thyolo 区和中部的 Ntcheu 区进行。培训了 500 名关键知情人，以识别可能患有多种 MSI 的儿童。确定的儿童被转介到筛查营地，由医学专家通过标准化评估方案对其进行检查，以诊断每种损伤形式。
15000 名儿童被转介到筛查营地。7220 名儿童接受了评估（应答率为 48%），其中 15.2%（1094 人）有 MSI。13%的儿童因创伤而出现 MSI，而 54%的儿童有神经病因。对于创伤性起源的 MSI，最常见的受伤部位是肘部。不到一半的 MSI 儿童（44.4%）在上学，这些儿童没有一个在有残疾资源的学校上学。超过一半的 MSI 儿童（60%）未获得所需服务，64%需要进一步的物理治疗。
KIM 方法用于确定马拉维两个地区儿童中 MSI 的高患病率，并估计对专门的 MSI 服务的需求未得到满足。
