Paediatric Osteomyelitis in a Tertiary Hospital in South-South Nigeria; Clinical Experience at Federal Medical Centre Asaba

Abstract

Background: The incidence of Osteomyelitis is disproportionately higher in low-income countries (43-200 per 100,000 children) compared to high-income countries (1.94-13 per 100,000 children).These infections remains a significant threat to proper growth and development of children in low-income countries, and this is partly due to late presentation to the hospital coupled with wanton unorthodox pre-hospital intervention by traditional healers. Aim: To determine the clinical and microbiological profile of paediatric osteomyelitis at Federal Medical Centre Asaba. Methods: This is a 4year single centre retrospective study of all paediatric osteomyelitis managed in this hospital from January 2014 to December 2018. Important data such as type (acute, subacute and chronic) of osteomyelitis, bone involved, bone sites (epiphyseal, metaphyseal or diaphyseal) affected, microbiological culture results (implicated microorganisms), and genotype, treatment and outcome of treatment were expressed as frequencies and mean ± standard deviations, and Pearson’s Chi square test was used to measure associations. P values ˂ .05 were considered statistically significant. Results: Forty (40) out of 3657 children had osteomyelitis, 17 (42.5%), 4(10%) and 19 (47.5%) were diagnosed with acute, subacute and chronic osteomyelitis respectively. The prevalence of osteomyelitis in this study was 1%. The children were between the ages of 6 months to 17 years with a mean age of 8.1 ± 4.23 years and spent an average of 19 ± 14 days on admission. Low and middle socioeconomic status were significantly associated with the risk of infection (P = .04). Tibia (47.5%) and femur (25%) were the commonest bones involved. Staphylococcus aureus accounted for 52.5% of cases and the metaphysis was the commonest site involved. The sickle cell heamoglobin to normal heamoglobin genotype ratio is 1:3. Out-come was favourable 87.5% of the cases. Conclusion: Low socioeconomic class is a risk factor for paediatric osteomyelitis in our locality. Early diagnosis and prompt treatment are vital in ensuring favourable outcome.