Institute of Ageing and Health, Newcastle University, Newcastle upon Tyne, UK.
Department of Microbiology and Immunology, Kilimanjaro Christian Medical University College, Moshi, Tanzania.
Paediatr Int Child Health. 2022 Feb;42(1):12-21. doi: 10.1080/20469047.2022.2062561. Epub 2022 Apr 22.
Musculoskeletal diseases (MSD) are a major contributor to the global burden of disease and disability, and disproportionally affect low- and middle-income countries; however, there is a dearth of epidemiological data. Affected children often face increased morbidity, social isolation and economic hardship.
To assess the spectrum and burden of paediatric MSD in children aged 5-18 years admitted to a major referral hospital in Tanzania.
This was a retrospective cohort study of children aged 5-18 years admitted to Kilimanjaro Christian Medical Centre (KCMC) whose initial diagnosis was recognised as a musculoskeletal condition by the International Classification of Diseases-10 between 1 January and 31 December 2017.
During 2017, 163 cases of confirmed paediatric MSD were admitted to KCMC, representing 21.2% of all admissions of children aged 5-18 years (769). Bone disease was the most common diagnosis. They comprised 106 (65.0%) traumatic fractures, 31 (19.0%) osteo-articular infections, 9 (5.5%) malunions and 3 (1.8%) pathological fractures. Congenital defects and rheumatic disease were relatively uncommon, accounting for only 6 (3.7%) and 4 (2.5%) MSD admissions, respectively.
The majority of cases of MSD were related to fractures, followed by osteo-articular infections, while recognised cases of rheumatic disease were rare. The study, although small, identified the sizeable burden and spectrum of paediatric MSD admitted to a hospital in Tanzania over a 12-month period and highlights the need for larger studies to inform the optimal allocation of health resources.
CI: confidence interval; HIC: high-income countries; HIV: human immunodeficiency virus; ICD-10: International Classification of Diseases 10; IQR: interquartile range; JIA: juvenile idiopathic arthritis; KCMC: Kilimanjaro Christian Medical Centre; LMIC: low- and middle-income countries; MSD: musculoskeletal diseases: NAI: non-accidental injury; NIHR: National Institute for Health Research; PAFLAR: Paediatric Society of the African League Against Rheumatism; RTA: road traffic accidents; SCD: sickle cell disease; SLE: systemic lupus erythematosus; SSA: sub-Saharan Africa.
肌肉骨骼疾病（MSD）是全球疾病和残疾负担的主要原因，不成比例地影响低收入和中等收入国家；然而，流行病学数据却很少。受影响的儿童往往面临更高的发病率、社会孤立和经济困难。
评估坦桑尼亚一家主要转诊医院收治的 5-18 岁儿童的儿科 MSD 谱和负担。
这是一项回顾性队列研究，纳入了 2017 年 1 月 1 日至 12 月 31 日期间因初始诊断为国际疾病分类第 10 版（ICD-10）中的肌肉骨骼疾病而被 Kilimanjaro Christian Medical Centre（KCMC）收治的 5-18 岁儿童。
2017 年，KCMC 收治了 163 例确诊的儿科 MSD 患儿，占所有 5-18 岁儿童（769 例）入院人数的 21.2%。骨病是最常见的诊断。其中 106 例（65.0%）为创伤性骨折，31 例（19.0%）为骨关节感染，9 例（5.5%）为畸形愈合，3 例（1.8%）为病理性骨折。先天性缺陷和风湿性疾病相对少见，分别占 MSD 入院人数的 6 例（3.7%）和 4 例（2.5%）。
大多数 MSD 病例与骨折有关，其次是骨关节感染，而风湿性疾病的确诊病例则很少见。尽管该研究规模较小，但它确定了在坦桑尼亚一家医院在 12 个月期间收治的儿科 MSD 的相当大的负担和范围，并强调需要进行更大规模的研究，以为最佳分配卫生资源提供信息。
CI：置信区间；HIC：高收入国家；HIV：人类免疫缺陷病毒；ICD-10：国际疾病分类第 10 版；IQR：四分位间距；JIA：幼年特发性关节炎；KCMC：Kilimanjaro Christian Medical Centre；LMIC：低收入和中等收入国家；MSD：肌肉骨骼疾病；NAI：非意外伤害；NIHR：英国国家卫生与临床优化研究所；PAFLAR：非洲反风湿病联盟儿科协会；RTA：道路交通意外；SCD：镰状细胞病；SLE：系统性红斑狼疮；SSA：撒哈拉以南非洲。
