The Burden of Musculoskeletal Injury in Low and Middle-Income Countries: Challenges and Opportunities

Spiegel, David A.; Gosselin, Richard A.; Coughlin, R. Richard; Joshipura, Manjul; Browner, Bruce D.; Dormans, John P.

doi:10.2106/jbjs.g.00637

Cited by 96 publications

(57 citation statements)

References 60 publications

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“…42,43 Injuries among older children who work in the informal sector to supplement the household income are economically disastrous. Over one-third of families (37%) paid for their care out-of-pocket because they lacked insurance.…”

Section: Special Theme -Childhood Injuries and Violence Unintentionalmentioning

confidence: 99%

Global childhood unintentional injury surveillance in four cities in developing countries: a pilot study

Hyder

Sugerman

Puvanachandra

et al. 2009

Bull World Health Org

195

158

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Objective To determine the frequency and nature of childhood injuries and to explore the risk factors for such injuries in low-income countries by using emergency department (ED) surveillance data. Methods This pilot study represents the initial phase of a multi-country global childhood unintentional injury surveillance (GCUIS) project and was based on a sequential sample of children < 11 years of age of either gender who presented to selected EDs in Bangladesh, Colombia, Egypt and Pakistan over a 3-4 month period, which varied for each site, in 2007. Findings Of 1559 injured children across all sites, 1010 (65%) were male; 941 (60%) were aged ³ 5 years, 32 (2%) were < 1 year old. Injuries were especially frequent (34%) during the morning hours. They occurred in and around the home in 56% of the cases, outside while children played in 63% and during trips in 11%. Of all the injuries observed, 913 (56%) involved falls; 350 (22%), road traffic injuries; 210 (13%), burns; 66 (4%), poisoning; and 20 (1%), near drowning or drowning. Falls occurred most often from stairs or ladders; road traffic injuries most often involved pedestrians; the majority of burns were from hot liquids; poisonings typically involved medicines, and most drowning occurred in the home. The mean injury severity score was highest for near drowning or drowning (11), followed closely by road traffic injuries (10). There were 6 deaths, of which 2 resulted from drowning, 2 from falls and 2 from road traffic injuries. Conclusion Hospitals in low-income countries bear a substantial burden of childhood injuries, and systematic surveillance is required to identify the epidemiological distribution of such injuries and understand their risk factors. Methodological standardization for surveillance across countries makes it possible to draw international comparisons and identify common issues.Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se facilita una traducción al español. ‫املقالة.‬ ‫لهذه‬ ‫الكامل‬ ‫النص‬ ‫نهاية‬ ‫يف‬ ‫الخالصة‬ ‫لهذه‬ ‫العربية‬ ‫الرتجمة‬

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Section: Special Theme -Childhood Injuries and Violence Unintentionalmentioning

confidence: 99%

Global childhood unintentional injury surveillance in four cities in developing countries: a pilot study

Hyder

Sugerman

Puvanachandra

et al. 2009

Bull World Health Org

195

158

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“…The large and increasing burden of musculoskeletal disease in low-and middle-income countries is poorly documented and largely neglected by the global health community [5,8,21,37]. Injury underlies 11.2% of all disability adjusted life years as reported by the Global Burden of Disease Study 2010 [29], with musculoskeletal injury estimated to account for 70% to 80% of reported injuries in one developing country (Sierra Leone) [39].…”

Section: Introductionmentioning

confidence: 99%

What Factors Influence the Production of Orthopaedic Research in East Africa? A Qualitative Analysis of Interviews

Elliott

Sonshine

Akhavan

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Research addressing the burden of musculoskeletal disease in low-and middle-income countries does not reflect the magnitude of the epidemic in these countries as only 9% of the world's biomedical resources are devoted to addressing problems that affect the health of 90% of the world's population. Little is known regarding the barriers to and drivers of orthopaedic surgery research in such resource-poor settings, the knowledge of which would help direct specific interventions for increasing research capacity and help surgeons from high-income countries support the efforts of our colleagues in low-and middle-income countries. Purpose We sought to identify through surveying academic orthopaedic surgeons in East Africa: (1) barriers impeding research, (2) factors that support or drive research, and (3) factors that were identified by some surgeons as barriers and others as drivers (what we term barrier-driver overlap) as they considered the production of clinical research in resource-poor environments. Materials Semistructured interviews were conducted with 21 orthopaedic surgeon faculty members at four academic medical centers in Ethiopia, Kenya, Tanzania, and Uganda. Qualitative content analysis of the interviews was conducted using methods based in grounded theory. Grounded theory begins with qualitative data, such as interview transcripts, and analyzes the data for repeated ideas or concepts which then are coded and grouped into categories which allow for identification of subjects or problems that may not have been apparent previously to the interviewer. Results We identified and quantified 19 barriers to and 21 drivers of orthopaedic surgery research (mentioned n = 1688 and n = 1729, respectively). Resource, research process, and institutional domains were identified to This study was supported by private donations to the Institute for Global Orthopaedics and Traumatology (IGOT, San Francisco, CA, USA). No authors received payment or in-kind benefit for this study, nor are any authors members of a company that provided funding to IGOT. Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. categorize the barriers (n = 7, n = 5, n = 7, respectively) and drivers (n = 7, n = 8, n = 6, respectively). Resource barriers (46%) were discussed more often by interview subjects compared with the research process (26%) and institutional barriers (28%). Drivers of research discussed at least once were proportionally similar across the three domains. Some themes such as research ethics boards, technology, and literature access occurred with similar frequency as barriers to and drivers of orthopaedic surgery research. Conclusions The barriers we identified most often among East African academic orthopaedic faculty members focused on resources to accomplish research, followed by institutional barriers, and method or process ba...

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“…1,2 Rising awareness among policy-makers of the burden of injury 3 has led to an increased need for easily quantifiable metrics to improve the allocation of resources for the treatment of injuries. [4][5][6][7][8][9][10][11] The intervals involved in the treatment of femur fractures -injury to admission, admission to surgery and surgery to discharge -are easily measurable and may be useful in evaluating the efficiency with which a trauma system treats an injured patient.…”

Section: Introductionmentioning

confidence: 99%

Time intervals in the treatment of fractured femurs as indicators of the quality of trauma systems

Matityahu

Elliott

Marmor

et al. 2013

Bull. World Health Organ.

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The Burden of Musculoskeletal Injury in Low and Middle-Income Countries: Challenges and Opportunities

Cited by 96 publications

References 60 publications

Global childhood unintentional injury surveillance in four cities in developing countries: a pilot study

Global childhood unintentional injury surveillance in four cities in developing countries: a pilot study

What Factors Influence the Production of Orthopaedic Research in East Africa? A Qualitative Analysis of Interviews

Time intervals in the treatment of fractured femurs as indicators of the quality of trauma systems

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