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BACKGROUND: When faced with developing orthopaedic services for children in Sub-Saharan Africa, there is little objective evidence-based data on the magnitude and type of services needed. Rwanda is a small country that is in the process of developing orthopaedic and rehabilitation services, and its Ministry of Health supported a survey that would provide information necessary for planning such services. METHODS: A national survey of musculoskeletal impairment (MSI) prevalence was undertaken. Of a population of 8.4 million, 8368 people were enumerated. Four thousand one hundred thirty-four were aged 16 years or less. Cases who failed a screening test for MSI were examined, allocated a diagnostic category, and assessed as to treatment needed. RESULTS: Of 4134 people aged 16 years or less who were enumerated, 3526 (85%) were screened and 91 had MSI, giving a prevalence of MSI among children of 2.58% (95% confidence interval; 2.06-3.10). Twenty-three percent of MSIs were a result of congenital deformity, 14% neurologic conditions, 12% trauma, 3% infection, and 46% other acquired pathology. Of the MSIs, 56.7% were mild, 37.8% moderate, and 5.6% severe. Extrapolated treatment needs suggest that 2% of Rwandan children (approximately 80,000) need orthopaedic physical therapy, 1.2% (50,000) need orthopaedic surgery, and approximately 10,000 need orthopaedic appliances. CONCLUSIONS: These results will be of use in planning future paediatric orthopaedic services in Rwanda, and for comparative studies in other low-income countries.

Type

Journal

Journal of pediatric orthopedics

Publication Date

12/2009

Volume

29

Pages

948 - 951

Addresses

London School of Hygiene and Tropical Medicine, London, UK.

Keywords

Humans, Musculoskeletal Diseases, Orthopedic Procedures, Health Care Surveys, Prevalence, Pilot Projects, Needs Assessment, Adolescent, Child, Health Services Needs and Demand, Rwanda, Female, Male, Physical Therapy Modalities