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Published on: July 15, 2009
Intranational variation in prosthetic user populations: A comparative analysis of prosthetic and orthotic centers in
Morgan H Alverson1, Ryan A Irving1, Nicola Y Bailey1
1Department of Engineering, King's College London, London, UK.
Background:
Population-level data on people with limb loss (PwLL) are needed for effective prosthetic provision and rehabilitation. These data are rare in low- and middle-income countries, and low- and middle-income countries are routinely dealt with as homogenous entities.
Objectives:
Here, we investigate intranational variation in PwLL populations in Sri Lanka using long-term routinely collected data from prosthetic and orthotic (P&O) clinics.
Study Design:
Retrospective study.
Methods:
Until 2009, Sri Lanka experienced a 26-year civil war affecting primarily northern/eastern districts. Published data from 2 P&O centers in northern (Jaffna Jaipur Centre for Disability Rehabilitation, JJCDR; 1987-2018) and central (Centre for Handicapped, CFH; 1987-2024) districts were compared to investigate intranational variation in PwLL demographics and temporal trends. Summative statistics, χ2, and Mann-Whitney U tests (α < 0.05) were used to quantify differences.
Results:
Major differences included a larger population of males at the CFH (88.8%) compared with the JJCDR (77.4%) and-although war-related amputations were most common at both clinics-there were relatively more war-related amputees at the JJCDR (CFH: 44.8%; JJCDR: 62.7%). In addition, the JJCDR had a higher proportion of patients registered and injured in the same district (CFH: 62.22%; JJCDR: 66.11%).
Conclusions:
Intranational variation in PwLL populations exists in Sri Lanka as evidenced by differences in populations between northern and central P&O clinics. This points toward differences in provisional needs and temporal health/societal trends underlying limb loss, which must be considered when provisioning health services.
