Paediatric chronic osteomyelitis at a government referral hospital in the Gambia

Abstract

Summary Data on the epidemiology of pediatrics osteomyelitis in sub-Saharan Africa is scarce. Children with chronic osteomyelitis (CO) were identified from a prospective paediatric surgery database at the main government referral hospital in Banjul, The Gambia. Hospital reported incidence of childhood osteomyelitis for Banjul and the Kanifing Municipal Area (two urban areas close to the hospital) was estimated from hospital records. From January 1996 - May 1998, 315 children aged 0-14 yrs were treated for CO accounting for 5.7% of paediatric surgical admissions and 15.4% of total paediatric surgical inpatient days. Eighty-five percent underwent sequestrectomy. The tibia (43%), femur (20%), and humerus (12%) were the commonest sites. Hospital reported incidence of paediatric chronic osteomyelitis in Banjul and the Kanifing Municipal Area (KMA) was 100 and 52 per 100,000 children, respectively. The incidence in Banjul is five times that reported for industrialized nations. CO is common in The Gambia and places a significant burden on the limited resources. Patients typically require sequestrectomy or debridement. While efforts at disease prevention include improving the general health of children in the region, early diagnosis and treatment is essential to reducing the burden of disease, the public and health professionals within each community need to be aware of the importance of early diagnosis and treatment of acute osteomyelitis which commonly precedes the development of chronic osteomyelitis.