Cargando…
Predictors of musculoskeletal manifestations in paediatric patients presenting with sickle cell disease at a tertiary teaching hospital in Lusaka, Zambia
AIMS: Sickle cell disease (SCD) is an autosomal recessive inherited condition that presents with a number of clinical manifestations that include musculoskeletal manifestations (MM). MM may present differently in different individuals and settings and the predictors are not well known. Herein, we ai...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The British Editorial Society of Bone and Joint Surgery
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7677731/ https://www.ncbi.nlm.nih.gov/pubmed/33225286 http://dx.doi.org/10.1302/2633-1462.16.BJO-2020-0013.R1 |
_version_ | 1783612035990290432 |
---|---|
author | Musowoya, Raymond Mpanjilwa Kaonga, Patrick Bwanga, Alick Chunda-Lyoka, Catherine Lavy, Christopher Munthali, James |
author_facet | Musowoya, Raymond Mpanjilwa Kaonga, Patrick Bwanga, Alick Chunda-Lyoka, Catherine Lavy, Christopher Munthali, James |
author_sort | Musowoya, Raymond Mpanjilwa |
collection | PubMed |
description | AIMS: Sickle cell disease (SCD) is an autosomal recessive inherited condition that presents with a number of clinical manifestations that include musculoskeletal manifestations (MM). MM may present differently in different individuals and settings and the predictors are not well known. Herein, we aimed at determining the predictors of MM in patients with SCD at the University Teaching Hospital, Lusaka, Zambia. METHODS: An unmatched case-control study was conducted between January and May 2019 in children below the age of 16 years. In all, 57 cases and 114 controls were obtained by systematic sampling method. A structured questionnaire was used to collect data. The different MM were identified, staged, and classified according to the Standard Orthopaedic Classification Systems using radiological and laboratory investigations. The data was entered in Epidata version 3.1 and exported to STATA 15 for analysis. Multiple logistic regression was used to determine predictors and predictive margins were used to determine the probability of MM. RESULTS: The cases were older median age 9.5 (interquartile range (IQR) 7 to 12) years compared to controls 7 (IQR 4 to 11) years; p = 0.003. After multivariate logistic regression, increase in age (adjusted odds ratio (AOR) = 1.2, 95% confidence interval (CI) 1.04 to 1.45; p = 0.043), increase in the frequency of vaso-occlusive crisis (VOC) (AOR = 1.3, 95% CI 1.09 to 1.52; p = 0.009) and increase in percentage of haemoglobin S (HbS) (AOR = 1.18, 95% CI 1.09 to 1.29; p < 0.001) were significant predictors of MM. Predictive margins showed that for a 16-year-old the average probability of having MM would be 51 percentage points higher than that of a two-year-old. CONCLUSION: Increase in age, frequency of VOC, and an increase in the percentage of HbS were significant predictors of MM. These predictors maybe useful to clinicians in determining children who are at risk. Cite this article: Bone Joint Open 2020;1-6:175–181. |
format | Online Article Text |
id | pubmed-7677731 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | The British Editorial Society of Bone and Joint Surgery |
record_format | MEDLINE/PubMed |
spelling | pubmed-76777312020-11-20 Predictors of musculoskeletal manifestations in paediatric patients presenting with sickle cell disease at a tertiary teaching hospital in Lusaka, Zambia Musowoya, Raymond Mpanjilwa Kaonga, Patrick Bwanga, Alick Chunda-Lyoka, Catherine Lavy, Christopher Munthali, James Bone Jt Open General Orthopaedics AIMS: Sickle cell disease (SCD) is an autosomal recessive inherited condition that presents with a number of clinical manifestations that include musculoskeletal manifestations (MM). MM may present differently in different individuals and settings and the predictors are not well known. Herein, we aimed at determining the predictors of MM in patients with SCD at the University Teaching Hospital, Lusaka, Zambia. METHODS: An unmatched case-control study was conducted between January and May 2019 in children below the age of 16 years. In all, 57 cases and 114 controls were obtained by systematic sampling method. A structured questionnaire was used to collect data. The different MM were identified, staged, and classified according to the Standard Orthopaedic Classification Systems using radiological and laboratory investigations. The data was entered in Epidata version 3.1 and exported to STATA 15 for analysis. Multiple logistic regression was used to determine predictors and predictive margins were used to determine the probability of MM. RESULTS: The cases were older median age 9.5 (interquartile range (IQR) 7 to 12) years compared to controls 7 (IQR 4 to 11) years; p = 0.003. After multivariate logistic regression, increase in age (adjusted odds ratio (AOR) = 1.2, 95% confidence interval (CI) 1.04 to 1.45; p = 0.043), increase in the frequency of vaso-occlusive crisis (VOC) (AOR = 1.3, 95% CI 1.09 to 1.52; p = 0.009) and increase in percentage of haemoglobin S (HbS) (AOR = 1.18, 95% CI 1.09 to 1.29; p < 0.001) were significant predictors of MM. Predictive margins showed that for a 16-year-old the average probability of having MM would be 51 percentage points higher than that of a two-year-old. CONCLUSION: Increase in age, frequency of VOC, and an increase in the percentage of HbS were significant predictors of MM. These predictors maybe useful to clinicians in determining children who are at risk. Cite this article: Bone Joint Open 2020;1-6:175–181. The British Editorial Society of Bone and Joint Surgery 2020-06-02 /pmc/articles/PMC7677731/ /pubmed/33225286 http://dx.doi.org/10.1302/2633-1462.16.BJO-2020-0013.R1 Text en © 2020 Author(s) et al. https://creativecommons.org/licenses/by-nc-nd/4.0/ Open Access This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc-nd/4.0/. |
spellingShingle | General Orthopaedics Musowoya, Raymond Mpanjilwa Kaonga, Patrick Bwanga, Alick Chunda-Lyoka, Catherine Lavy, Christopher Munthali, James Predictors of musculoskeletal manifestations in paediatric patients presenting with sickle cell disease at a tertiary teaching hospital in Lusaka, Zambia |
title | Predictors of musculoskeletal manifestations in paediatric patients presenting with sickle cell disease at a tertiary teaching hospital in Lusaka, Zambia |
title_full | Predictors of musculoskeletal manifestations in paediatric patients presenting with sickle cell disease at a tertiary teaching hospital in Lusaka, Zambia |
title_fullStr | Predictors of musculoskeletal manifestations in paediatric patients presenting with sickle cell disease at a tertiary teaching hospital in Lusaka, Zambia |
title_full_unstemmed | Predictors of musculoskeletal manifestations in paediatric patients presenting with sickle cell disease at a tertiary teaching hospital in Lusaka, Zambia |
title_short | Predictors of musculoskeletal manifestations in paediatric patients presenting with sickle cell disease at a tertiary teaching hospital in Lusaka, Zambia |
title_sort | predictors of musculoskeletal manifestations in paediatric patients presenting with sickle cell disease at a tertiary teaching hospital in lusaka, zambia |
topic | General Orthopaedics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7677731/ https://www.ncbi.nlm.nih.gov/pubmed/33225286 http://dx.doi.org/10.1302/2633-1462.16.BJO-2020-0013.R1 |
work_keys_str_mv | AT musowoyaraymondmpanjilwa predictorsofmusculoskeletalmanifestationsinpaediatricpatientspresentingwithsicklecelldiseaseatatertiaryteachinghospitalinlusakazambia AT kaongapatrick predictorsofmusculoskeletalmanifestationsinpaediatricpatientspresentingwithsicklecelldiseaseatatertiaryteachinghospitalinlusakazambia AT bwangaalick predictorsofmusculoskeletalmanifestationsinpaediatricpatientspresentingwithsicklecelldiseaseatatertiaryteachinghospitalinlusakazambia AT chundalyokacatherine predictorsofmusculoskeletalmanifestationsinpaediatricpatientspresentingwithsicklecelldiseaseatatertiaryteachinghospitalinlusakazambia AT lavychristopher predictorsofmusculoskeletalmanifestationsinpaediatricpatientspresentingwithsicklecelldiseaseatatertiaryteachinghospitalinlusakazambia AT munthalijames predictorsofmusculoskeletalmanifestationsinpaediatricpatientspresentingwithsicklecelldiseaseatatertiaryteachinghospitalinlusakazambia |