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The burden of hospital admissions for skeletal dysplasias in Sri Lanka: a population-based study
Yasas D Kolambage1,2, Yasaswi N Walpita3, Udari A Liyanage4
1Department of Anatomy, Faculty of Medicine, Sabaragamuwa University of Sri Lanka, Ratnapura, Sri Lanka. yasas@med.sab.ac.lk.
Insights
Skeletal dysplasias, rare bone disorders, show a female predominance in Sri Lanka, with osteogenesis imperfecta being the most common diagnosis. Further research is needed to understand the healthcare burden and reduce admission rates.
Area of Science:
- Epidemiology
- Rare Diseases
- Orthopedics
Background:
- Skeletal dysplasias are rare chondro-osseous disorders affecting functionality, with a global prevalence of approximately 1:5000 births.
- No prior epidemiological studies have detailed the disease burden and trends of skeletal dysplasias in Sri Lanka.
Purpose of the Study:
- To evaluate the burden and current trends of hospital admissions for skeletal dysplasias in Sri Lanka.
- To analyze admission trends by year, age, and specific dysplasia types.
Main Methods:
- Retrospective analysis of hospital admission data for skeletal dysplasia from 2017-2020.
- Utilized population-based data from the eIMMR database covering all government hospitals in Sri Lanka.
- Descriptive statistics were used to analyze trends in admissions.
Main Results:
- Crude admission rates ranged from 5.2 to 8.1 per million population between 2017-2020.
- A female predominance (1.4:1) was observed, with the majority of cases (44.2%) being children under 4 years old.
- Osteogenesis imperfecta accounted for 60% of diagnoses, with rising admission trends for osteogenesis imperfecta, achondroplasia, and osteopetrosis.
Conclusions:
- The study identified a female predominance and high rate of osteogenesis imperfecta admissions in Sri Lanka.
- Distinct trends were obscured, potentially by the COVID-19 pandemic's impact on healthcare services.
- Further research on the family healthcare burden and cost of care is recommended to identify therapies that can reduce admission rates.
Background:
Skeletal dysplasias are a diverse group of rare disorders in the chondro-osseous tissue that can have a significant impact on patient's functionality. The worldwide prevalence of skeletal dysplasias at birth is approximately 1:5000 births. To date, disease burden and trends of skeletal dysplasias in the Sri Lankan population have not been described in any epidemiological study. Our aim was to evaluate the burden and the current trends in hospital admissions for skeletal dysplasias in the Sri Lankan population. A retrospective evaluation of hospital admissions for skeletal dysplasia during 2017-2020 was performed using population-based data from the eIMMR database which covers government hospitals in the entire country. The trends in hospital admissions for skeletal dysplasias by calendar year, age, and types of skeletal dysplasia were described using appropriate summary statistics.
Results:
Respective crude admission rates of skeletal dysplasias in the years 2017, 2018, 2019 and 2020 were 5.2, 8.1, 8.0, and 6.5 per million population. A female predominance (1.4:1) was noted during the studied period. Of all reported cases the majority (n = 268; 44.2%) were children less than 4 years. Each year, 0-4 years age group represented 40-47% of the total hospital admissions. More than half of the cases were reported from Colombo (28.1%) and Kandy (25.4%) districts combined. 60% of cases were diagnosed as osteogenesis imperfecta (OI). Rising trends were observed in the hospital admissions for osteogenesis imperfecta, achondroplasia and osteopetrosis, while other skeletal dysplasia types collectively showed a relatively stable trend.
Conclusion:
This preliminary study revealed a female predominance of skeletal dysplasias and a relatively high admission rate of osteogenesis imperfecta in the Sri Lankan population. A distinct trend was not visible in the studied years probably due to the impact on hospital services due to COVID- Pandemic. Future research on the healthcare burden on families affected by skeletal dysplasia is required to better understand the overall cost of care and identify therapies that reduce admission rates. This study highlights the value of analysing population-based data on rare diseases to improve healthcare in low-resource countries.
