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The spectrum and burden of in-patient paediatric musculoskeletal diseases in Northern Tanzania

Lookup NU author(s): Rebecca Walsh, Dr Clive Kelly, Professor Richard Walker



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Background: 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. Aim: To assess the spectrum and burden of paediatric MSD in children aged 5–18 years admitted to a major referral hospital in Tanzania. Methods: 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. Results: During 2017, 163 cases of confirmed paediatric MSD were admitted to KCMC, representing 21.2% of all admissions of children aged 5–18 years (n = 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. Conclusion: 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. Abbreviation: 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.

Publication metadata

Author(s): Walsh RB, Mwingwa A, Yongolo NM, Biswaro SM, Mwanswila MJ, Kelly C, Mmbaga BT, Mosha F, Gray WK, McIntosh E, Walker RW

Publication type: Article

Publication status: Published

Journal: Paediatrics and International Child Health

Year: 2022

Volume: 42

Issue: 1

Pages: 12-21

Online publication date: 22/04/2022

Acceptance date: 30/03/2022

Date deposited: 23/05/2022

ISSN (print): 2046-9047

ISSN (electronic): 2046-9055

Publisher: Taylor and Francis Ltd


DOI: 10.1080/20469047.2022.2062561

PubMed id: 35452362


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Funder referenceFunder name
17/63/35National Institute for Health Research (NIHR)