Risk factors and socio-economic burden of chronic osteomylitis amongst patients admitted on surgical ward of Kampala International University teaching hospital

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Kampala International University. School of Health Sciences Western Campus
Background: Chronic osteomyelitis is a severe, persistent and sometimes incapacitating infection of the bone or bone marrow caused by bacteria or fungal infection when enters bone tissue from bloodstream, due to injury or surgery with Staphylococcus aureus as the leading cause followed by haemophilus influenza and salmonella infection in sickle cell patient ( Schmitt, 2017). Methodology: A retrospective data collection method was used and files of 400 patients who were admitted on surgical ward in Kampala international university teaching hospital from June 2012 to July 2017 were reviewed. Questionnaires were filled and Microsoft word was used to analyze data. The data was presented in form of pie charts, Bar graphs, frequency table. Results: There were 285(71.25%) males and 115(28.75%) females, 60% of the patients were between 16-30years of age, and 77.5% of patients come from rural areas, urban areas accounted for 22.5% and 70% of them unemployed with biggest percentage of 60% primary drop outs. The risk factors for chronic osteomyelitis noted among patients included upper respiratory tract infections with 43%, 25% trauma, 10% HIV/AIDs, 8% surgery, 7% poor hygiene, 2%DM, 0.05% SCD among others were noted. 85% of patients were diagnosed using x-ray, 5%blood culture which indicated staphylococcus aureus as the cause and salmonella in SCD with CBC, CRP and ESR as baseline investigations were used scoring 8% and 2%MRI. Antibiotics including ceftriaxone, flucamox and cloxacillin in 36% patients and sequestrectomy in 62% of patients plus amputation in 1% of patients were used as management modalities. 50% of patients were hospitalized for 3months with a charge between 131.6-263.2 US dollars on discharge , 35% for one month charged between 52.6- 131.6 US dollars followed by 10% six months with a charge of 263.2 -789.5 US dollars and 5% > six months were the least charged >789.5 US dollars. 70% ended up with inability to walk, 20% with pathological fractures, 6% internal fixators and 4% had no complications. Conclusion: chronic osteomyelitis is still a socio-economic burden with catastrophic and irreversible complications which needs effective and urgent preventive and curative measures within the community.
A research report submitted to the faculty of medicine and dentistry in partial fulfillment of the requirement for the award of bachelor of medicine and bachelor of surgery degree of Kampala International University
Chronic osteomylitis, patients, Kampala International University teaching hospital