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Musculoskeletal conditions in children attending two Togolese hospitals
M Mijiyawa1, O Oniankitan, K Attoh-Mensah
1Service de rhumatologie, CHU-Tokoin de Lomé, Togo.
Insights
Musculoskeletal conditions like infections and deformities are prevalent in Togolese children, with sickle cell disease being a significant risk factor. Early investigation for sickle cell anaemia is crucial for joint and bone pain in African children.
Area of Science:
- Pediatric Orthopedics
- Infectious Diseases
- Genetics
Background:
- Musculoskeletal conditions represent a significant health concern in pediatric populations.
- Understanding the epidemiology of these conditions is vital for targeted healthcare interventions.
Purpose of the Study:
- To identify and categorize the spectrum of musculoskeletal conditions in children treated at two hospitals in Togo.
- To analyze the prevalence and types of bone and joint diseases in this demographic.
Main Methods:
- A retrospective analysis of pediatric patient records from two Togolese hospitals.
- Data collected included patient demographics, diagnoses, and affected anatomical sites.
Main Results:
- 1.5% of 29,620 children (434 cases) had musculoskeletal conditions.
- Key conditions included probable joint/bone infections (43%), limb deformities (24%), osteochondrosis (14%), and sickle cell-related crises (7%).
- Osteomyelitis, infectious arthritis, Scheuermann's disease, Legg-Calvé-Perthes disease, and talipes varus equinus were frequently observed.
Conclusions:
- Sickle cell disease is a major risk factor for bone and joint infections and vaso-occlusive crises in children.
- Limb deformities like genu varum/valgum may contribute to knee osteoarthritis in adulthood.
- Prompt investigation for sickle cell anaemia is recommended for African children presenting with bone or joint pain.
Objective:
A retrospective study was conducted in order to point out the different kinds of musculoskeletal conditions observed in children attending two Togolese hospitals.
Results:
A total of 434 (242 females, 192 males) of the 29 620 children examined (1.5%) were suffering from these conditions. Probable joint and bone infections (187 patients, 43%), limb deformities (106 patients, 24%), osteochondrosis (60 patients, 14%) and vaso-occlusive crisis due to haemoglobinopathies (29 patients, 7%) were the main conditions observed. Osteomyelitis observed in 128 patients affected the humerus (25 patients), radius (10 patients), femur (68 patients), tibia (15 patients), fibula (five patients), and both tibia and fibula (five patients). Probably, infectious arthritis seen in 30 patients affected mainly the hip (11 patients) and the knee (13 patients). In the spine, infection affected the midthoracic and upper lumbar areas. Underdevelopment, sickle cell anaemia and sickle cell haemoglobin C disease were the main risk factors in determining susceptibility to infections. Vaso-occlusive crises were due to sickle cell anaemia (11 patients) and sickle cell haemoglobin C disease (18 patients). Osteochondrosis seen in 60 patients free from haemoglobinopathy involved the spine (Scheuermann's disease, 38 patients) and the hip (Legg-Calvé-Perthes disease, 22 patients). Limb deformities were observed in the knee (varus and valgus deformities in 64 patients) and the foot (talipes varus equin in 40 patients).
Conclusion:
This study's findings, which require further confirmation, suggest some conclusions. Scheuermann's disease can explain in part the degenerative disc conditions observed in African adults. Valgus and varus deformities play an important role in the development of knee osteoarthritis in Black Africa. An African child with joint or bone pain should be investigated for sickle cell anaemia. In the future, improved lifestyle and better health care will be essential to reduce bone and joint infections, and allow refined diagnosis of connective tissue diseases now probably underestimated in African children.