المؤلفون: Song, Siyou, Muhumuza, Moses Fisha, Penny, Norgrove, Sabatini, Coleen S

المصدر: BMC Musculoskeletal Disorders. 23(1)

مصطلحات موضوعية: Allied Health and Rehabilitation Science, Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Pediatric, Patient Safety, Clinical Research, Musculoskeletal, Good Health and Well Being, Child, Foot Deformities, Humans, Iatrogenic Disease, Injections, Intramuscular, Paralysis, Retrospective Studies, Treatment Outcome, Post-injection paralysis, Intramuscular injection, Pediatrics, Iatrogenic disability, Orthopedics, Clinical sciences, Allied health and rehabilitation science, Sports science and exercise

الوصف: BackgroundPost-injection paralysis (PIP) of the sciatic nerve is an iatrogenic paralysis that occurs after an intramuscular injection, with resultant foot deformity and disability. This study investigates the epidemiology and treatment of PIP in Uganda.MethodsHealth records of pediatric patients surgically treated for PIP at the CoRSU Rehabilitation Hospital from 2013 to 2018 were retrospectively reviewed. Pre-operative demographics, perioperative management, and outcomes were coded and analyzed with descriptive statistics, chi-square for categorical variables, and linear models for continuous variables.ResultsFour-hundred and two pediatric patients underwent 491 total procedures. Eighty-three percent of reported injection indications were for febrile illness. Twenty-five percent of reported injections explicitly identified quinine as the agent. Although ten different procedures were performed, achilles tendon lengthening, triple arthrodesis, tibialis posterior and anterior tendon transfers composed 83% of all conducted surgeries. Amongst five different foot deformities, equinus and varus were most likely to undergo soft tissue and bony procedures, respectively (p=0.0223). Ninteen percent of patients received two or more surgeries. Sixty-seven percent of patients achieved a plantigrade outcome; 13.61% had not by the end of the study period; 19.3% had unreported outcomes. Those who lived further from the facility had longer times between the inciting injection and initial hospital presentation (p=0.0216) and were more likely to be lost to follow-up (p=0.0042).ConclusionPIP is a serious iatrogenic disability. Prevention strategies are imperative, as over 400 children required 491 total surgical procedures within just six years at one hospital in Uganda.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/2tp661c8Test

المؤلفون: Siyou Song, Moses Fisha Muhumuza, Norgrove Penny, Coleen S. Sabatini

المصدر: BMC Musculoskeletal Disorders, Vol 23, Iss 1, Pp 1-10 (2022)

مصطلحات موضوعية: Post-injection paralysis, Intramuscular injection, Pediatrics, Iatrogenic disability, Diseases of the musculoskeletal system, RC925-935

الوصف: Abstract Background Post-injection paralysis (PIP) of the sciatic nerve is an iatrogenic paralysis that occurs after an intramuscular injection, with resultant foot deformity and disability. This study investigates the epidemiology and treatment of PIP in Uganda. Methods Health records of pediatric patients surgically treated for PIP at the CoRSU Rehabilitation Hospital from 2013 to 2018 were retrospectively reviewed. Pre-operative demographics, perioperative management, and outcomes were coded and analyzed with descriptive statistics, chi-square for categorical variables, and linear models for continuous variables. Results Four-hundred and two pediatric patients underwent 491 total procedures. Eighty-three percent of reported injection indications were for febrile illness. Twenty-five percent of reported injections explicitly identified quinine as the agent. Although ten different procedures were performed, achilles tendon lengthening, triple arthrodesis, tibialis posterior and anterior tendon transfers composed 83% of all conducted surgeries. Amongst five different foot deformities, equinus and varus were most likely to undergo soft tissue and bony procedures, respectively (p=0.0223). Ninteen percent of patients received two or more surgeries. Sixty-seven percent of patients achieved a plantigrade outcome; 13.61% had not by the end of the study period; 19.3% had unreported outcomes. Those who lived further from the facility had longer times between the inciting injection and initial hospital presentation (p=0.0216) and were more likely to be lost to follow-up (p=0.0042). Conclusion PIP is a serious iatrogenic disability. Prevention strategies are imperative, as over 400 children required 491 total surgical procedures within just six years at one hospital in Uganda.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2474Test

الوصول الحر: https://doaj.org/article/85ddae2d31014140ba02357ded2b092eTest

المؤلفون: Alves, Kristin, Penny, Norgrove, Ekure, John, Olupot, Robert, Kobusingye, Olive, Katz, Jeffrey N, Sabatini, Coleen S

المصدر: BMC Musculoskeletal Disorders. 19(1)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Clinical Research, Pediatric, Prevention, Buttocks, Child, Child, Preschool, Female, Fibrosis, Humans, Injections, Intramuscular, Male, Paralysis, Prevalence, Retrospective Studies, Rural Health, Uganda, Gluteal fibrosis, Post-injection paralysis, Orthopedics, Clinical sciences, Allied health and rehabilitation science, Sports science and exercise

الوصف: BackgroundThe purpose of this study was to estimate the prevalence of postinjection paralysis (PIP) and gluteal fibrosis (GF) among children treated in a rural Ugandan Hospital.MethodsWe conducted a retrospective cohort study by reviewing the musculoskeletal clinic and community outreach logs for children (age

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/82b3m32wTest

المؤلفون: Alves, Kristin, Godwin, Christine L, Chen, Angela, Akellot, Daniella, Katz, Jeffrey N, Sabatini, Coleen S

المصدر: BMC Health Services Research. 18(1)

مصطلحات موضوعية: Health Services and Systems, Health Sciences, Clinical Research, Prevention, Health Services, 8.1 Organisation and delivery of services, Health and social care services research, Good Health and Well Being, Adult, Attitude of Health Personnel, Buttocks, Child, Delivery of Health Care, Female, Fibrosis, Health Personnel, Humans, Iatrogenic Disease, Injections, Intramuscular, Interviews as Topic, Male, Middle Aged, Motivation, Paralysis, Qualitative Research, Uganda, Gluteal fibrosis, Post-injection paralysis, Injection practices, Safe injection, Pediatric musculoskeletal health, Pediatric orthopaedics, Intramuscular injection, Library and Information Studies, Nursing, Public Health and Health Services, Health Policy & Services, Health services and systems, Public health

الوصف: BackgroundIatrogenic injection injury is a major cause of disability in Ugandan children. Two injuries thought to result from injection of medications into the gluteal region include post-injection paralysis (PIP) and gluteal fibrosis (GF). This study aimed to describe perceptions of local health care workers regarding risk factors, particularly injections, for development of GF and PIP. Specifically, we examine the role of injection practices in the development of these injuries by interviewing a diverse cohort of individuals working in the health sector.MethodsWe conducted a qualitative study in the Kumi and Wakiso Districts of Uganda in November 2017, utilizing 68 key informant interviews with individuals working in healthcare related fields. Interviews were structured utilizing a moderator guide focusing on injection practices, gluteal fibrosis and post-injection paralysis.ResultsWe identified six themes regarding perceptions of the cause of GF and PIP and organized these themes into a theoretical framework. There was a consensus among the individuals working in healthcare that inadequacies of the health care delivery system may lead to inappropriate intramuscular injection practices, which are presumed to contribute to the development of GF and PIP. Poor access to medications and qualified personnel has led to the proliferation of private clinics, which are often staffed by under-trained practitioners. Misaligned economic incentives and a lack of training may also motivate practitioners to administer frequent intramuscular injections, which cost more than oral medications. A lack of regulatory enforcement enables these practices to persist. However, due to limited community awareness, patients often perceive these practitioners as appropriately trained, and the patients frequently prefer injections over alternative treatment modalities.ConclusionThis qualitative study suggests that inappropriate intramuscular injections, may arise from problems in the health care delivery system. To prevent the disability of GF and PIP, it is important to not only address the intramuscular injections practices in Uganda, but also to examine upstream deficits in access, education, and policy enforcement.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/3nq1t9sfTest

المؤلفون: Alves, Kristin, Penny, Norgrove, Kobusingye, Olive, Olupot, Robert, Katz, Jeffrey N, Sabatini, Coleen S

المصدر: International Orthopaedics. 42(8)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Pediatric, Brain Disorders, Neurosciences, Rehabilitation, Infection, Musculoskeletal, Adolescent, Child, Child, Preschool, Cohort Studies, Cost of Illness, Cross-Sectional Studies, Female, Humans, Infant, Male, Musculoskeletal Diseases, Prevalence, Retrospective Studies, Surveys and Questionnaires, Uganda, Pediatric musculoskeletal health, Pediatric orthopaedics, Gluteal fibrosis, Post-injection paralysis, MSK burden, Orthopedics, Clinical sciences

الوصف: PurposeThe purpose of this study is to estimate the burden of musculoskeletal disease among children treated in Kumi District, Uganda, to inform training, capacity-building efforts, and resource allocation.MethodsWe conducted a retrospective cohort study by reviewing the musculoskeletal (MSK) clinic and community outreach logs for children (age

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/2253879tTest

المؤلفون: Kristin Alves, Christine L. Godwin, Angela Chen, Daniella Akellot, Jeffrey N. Katz, Coleen S. Sabatini

المصدر: BMC Health Services Research, Vol 18, Iss 1, Pp 1-11 (2018)

مصطلحات موضوعية: Gluteal fibrosis, Post-injection paralysis, Uganda, Injection practices, Safe injection, Pediatric musculoskeletal health, Public aspects of medicine, RA1-1270

الوصف: Abstract Background Iatrogenic injection injury is a major cause of disability in Ugandan children. Two injuries thought to result from injection of medications into the gluteal region include post-injection paralysis (PIP) and gluteal fibrosis (GF). This study aimed to describe perceptions of local health care workers regarding risk factors, particularly injections, for development of GF and PIP. Specifically, we examine the role of injection practices in the development of these injuries by interviewing a diverse cohort of individuals working in the health sector. Methods We conducted a qualitative study in the Kumi and Wakiso Districts of Uganda in November 2017, utilizing 68 key informant interviews with individuals working in healthcare related fields. Interviews were structured utilizing a moderator guide focusing on injection practices, gluteal fibrosis and post-injection paralysis. Results We identified six themes regarding perceptions of the cause of GF and PIP and organized these themes into a theoretical framework. There was a consensus among the individuals working in healthcare that inadequacies of the health care delivery system may lead to inappropriate intramuscular injection practices, which are presumed to contribute to the development of GF and PIP. Poor access to medications and qualified personnel has led to the proliferation of private clinics, which are often staffed by under-trained practitioners. Misaligned economic incentives and a lack of training may also motivate practitioners to administer frequent intramuscular injections, which cost more than oral medications. A lack of regulatory enforcement enables these practices to persist. However, due to limited community awareness, patients often perceive these practitioners as appropriately trained, and the patients frequently prefer injections over alternative treatment modalities. Conclusion This qualitative study suggests that inappropriate intramuscular injections, may arise from problems in the health care delivery system. To prevent the disability of GF and PIP, it is important to not only address the intramuscular injections practices in Uganda, but also to examine upstream deficits in access, education, and policy enforcement.

وصف الملف: electronic resource

العلاقة: http://link.springer.com/article/10.1186/s12913-018-3711-8Test; https://doaj.org/toc/1472-6963Test

الوصول الحر: https://doaj.org/article/c7780395f0084e788266db49775e38d7Test

المؤلفون: Kristin Alves, Norgrove Penny, John Ekure, Robert Olupot, Olive Kobusingye, Jeffrey N. Katz, Coleen S. Sabatini

المصدر: BMC Musculoskeletal Disorders, Vol 19, Iss 1, Pp 1-6 (2018)

مصطلحات موضوعية: Gluteal fibrosis, Post-injection paralysis, Diseases of the musculoskeletal system, RC925-935

الوصف: Abstract Background The purpose of this study was to estimate the prevalence of postinjection paralysis (PIP) and gluteal fibrosis (GF) among children treated in a rural Ugandan Hospital. Methods We conducted a retrospective cohort study by reviewing the musculoskeletal clinic and community outreach logs for children (age

وصف الملف: electronic resource

العلاقة: http://link.springer.com/article/10.1186/s12891-018-2254-9Test; https://doaj.org/toc/1471-2474Test

الوصول الحر: https://doaj.org/article/723edd3175cf4c409eed94b7a5795b48Test

المؤلفون: Coleen S. Sabatini, Olive Kobusingye, Norgrove Penny, Robert Olupot, Kristin Alves, Jeffrey N. Katz

المصدر: International orthopaedics, vol 42, iss 8

مصطلحات موضوعية: Male, Pediatrics, Cross-sectional study, Pediatric orthopaedics, Cohort Studies, 0302 clinical medicine, Cost of Illness, Surveys and Questionnaires, Prevalence, Paralysis, Uganda, Orthopedics and Sports Medicine, Musculoskeletal Diseases, 030212 general & internal medicine, Child, Pediatric, education.field_of_study, Pediatric musculoskeletal health, Rehabilitation, Child, Preschool, 030220 oncology & carcinogenesis, Female, medicine.symptom, Infection, medicine.medical_specialty, Adolescent, Clinical Sciences, Population, Article, Cerebral palsy, 03 medical and health sciences, Clinical Research, Post-injection paralysis, medicine, Humans, Preschool, education, Disease burden, Retrospective Studies, Muscle contracture, Gluteal fibrosis, business.industry, Neurosciences, Infant, Retrospective cohort study, medicine.disease, Brain Disorders, MSK burden, Cross-Sectional Studies, Orthopedics, Musculoskeletal, Orthopedic surgery, Surgery, business

الوصف: PurposeThe purpose of this study is to estimate the burden of musculoskeletal disease among children treated in Kumi District, Uganda, to inform training, capacity-building efforts, and resource allocation.MethodsWe conducted a retrospective cohort study by reviewing the musculoskeletal (MSK) clinic and community outreach logs for children (age

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d7c8308b544c2fdb4a92c55dd4359265Test
https://doi.org/10.1007/s00264-018-3915-xTest

المؤلفون: Angela Chen, Coleen S. Sabatini, Jeffrey N. Katz, Kristin Alves, Christine L. Godwin, Daniella Akellot

المصدر: BMC Health Services Research
BMC health services research, vol 18, iss 1
BMC Health Services Research, Vol 18, Iss 1, Pp 1-11 (2018)

مصطلحات موضوعية: Male, Pediatric orthopaedics, Iatrogenic Disease, 8.1 Organisation and delivery of services, Health informatics, Health administration, 0302 clinical medicine, Health care, Safe injection, Medicine, Uganda, 030212 general & internal medicine, Child, Qualitative Research, Intramuscular, 030504 nursing, Health Policy, Nursing research, lcsh:Public aspects of medicine, Pediatric musculoskeletal health, Health Services, Middle Aged, 3. Good health, Public Health and Health Services, Health Policy & Services, Female, 0305 other medical science, Intramuscular injection, Health and social care services research, Research Article, Adult, medicine.medical_specialty, Attitude of Health Personnel, Health Personnel, Injection practices, Nursing, Injections, Intramuscular, Injections, Interviews as Topic, 03 medical and health sciences, Library and Information Studies, Clinical Research, Post-injection paralysis, Humans, Paralysis, Motivation, Modalities, business.industry, Gluteal fibrosis, Public health, Prevention, lcsh:RA1-1270, Fibrosis, Good Health and Well Being, Family medicine, Buttocks, business, Delivery of Health Care, Qualitative research

الوصف: Background Iatrogenic injection injury is a major cause of disability in Ugandan children. Two injuries thought to result from injection of medications into the gluteal region include post-injection paralysis (PIP) and gluteal fibrosis (GF). This study aimed to describe perceptions of local health care workers regarding risk factors, particularly injections, for development of GF and PIP. Specifically, we examine the role of injection practices in the development of these injuries by interviewing a diverse cohort of individuals working in the health sector. Methods We conducted a qualitative study in the Kumi and Wakiso Districts of Uganda in November 2017, utilizing 68 key informant interviews with individuals working in healthcare related fields. Interviews were structured utilizing a moderator guide focusing on injection practices, gluteal fibrosis and post-injection paralysis. Results We identified six themes regarding perceptions of the cause of GF and PIP and organized these themes into a theoretical framework. There was a consensus among the individuals working in healthcare that inadequacies of the health care delivery system may lead to inappropriate intramuscular injection practices, which are presumed to contribute to the development of GF and PIP. Poor access to medications and qualified personnel has led to the proliferation of private clinics, which are often staffed by under-trained practitioners. Misaligned economic incentives and a lack of training may also motivate practitioners to administer frequent intramuscular injections, which cost more than oral medications. A lack of regulatory enforcement enables these practices to persist. However, due to limited community awareness, patients often perceive these practitioners as appropriately trained, and the patients frequently prefer injections over alternative treatment modalities. Conclusion This qualitative study suggests that inappropriate intramuscular injections, may arise from problems in the health care delivery system. To prevent the disability of GF and PIP, it is important to not only address the intramuscular injections practices in Uganda, but also to examine upstream deficits in access, education, and policy enforcement.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7d66d3416cf55fac2088fd258efe76ebTest
https://pubmed.ncbi.nlm.nih.gov/30477506Test

المؤلفون: Norgrove Penny, Olive Kobusingye, Robert Olupot, Coleen S. Sabatini, Jeffrey N. Katz, Kristin Alves, John Ekure

المصدر: Alves, K; Penny, N; Ekure, J; Olupot, R; Kobusingye, O; Katz, JN; et al.(2018). Burden of gluteal fibrosis and post-injection paralysis in the children of Kumi District in Uganda. BMC MUSCULOSKELETAL DISORDERS, 19. doi: 10.1186/s12891-018-2254-9. UCSF: Retrieved from: http://www.escholarship.org/uc/item/82b3m32wTest
BMC musculoskeletal disorders, vol 19, iss 1
BMC Musculoskeletal Disorders, Vol 19, Iss 1, Pp 1-6 (2018)

مصطلحات موضوعية: Male, medicine.medical_specialty, lcsh:Diseases of the musculoskeletal system, Sports medicine, medicine.medical_treatment, Clinical Sciences, Rural Health, Injections, Intramuscular, Injections, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Fibrosis, Clinical Research, Internal medicine, Epidemiology, Post-injection paralysis, Paralysis, Prevalence, Medicine, Humans, Orthopedics and Sports Medicine, Uganda, 030212 general & internal medicine, Child, Preschool, Retrospective Studies, Pediatric, 030222 orthopedics, Intramuscular, Rehabilitation, business.industry, Gluteal fibrosis, Prevention, Retrospective cohort study, medicine.disease, Orthopedics, Child, Preschool, Orthopedic surgery, Buttocks, Female, lcsh:RC925-935, medicine.symptom, business

الوصف: Background: The purpose of this study was to estimate the prevalence of postinjection paralysis (PIP) and gluteal fibrosis (GF) among children treated in a rural Ugandan Hospital. Methods: We conducted a retrospective cohort study by reviewing the musculoskeletal clinic and community outreach logs for children (age

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::df5b50089f8d062ff1500d54fdac5d64Test