Predictors of healthcare seeking delays among children with chronic musculoskeletal disorders in Nepal

Drake G. LeBrun; Divya Talwar; Tuyetnhi A. Pham; Bibek Banskota; David A. Spiegel

doi:10.1016/j.jegh.2017.10.002

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Volume 7, Issue 4, December 2017, Pages 299 - 304

Predictors of healthcare seeking delays among children with chronic musculoskeletal disorders in Nepal

Authors

Drake G. LeBrun^a^{, *}^,lebrund@uphs.upenn.edu, Divya Talwar^b^,talward@email.chop.edu, Tuyetnhi A. Pham^c^,annapham@alumni.upenn.edu, Bibek Banskota^d^,bbhospital@wlink.com.np, David A. Spiegel^b^{, d}^,spiegeld@email.chop.edu

^aPerelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

^bDivision of Orthopaedic Surgery, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

^cThe Wharton School, University of Pennsylvania, Philadelphia, PA, USA

^dDepartment of Orthopaedics, Hospital and Rehabilitation Centre for Disabled Children, Banepa, Nepal

^* Corresponding author at: Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd., Building 421, Philadelphia, PA 19104, USA.

Corresponding Author

Drake G. LeBrunlebrund@uphs.upenn.edu

Received 2 February 2017, Revised 14 August 2017, Accepted 2 October 2017, Available Online 12 October 2017.

DOI: 10.1016/j.jegh.2017.10.002 How to use a DOI?
Keywords: Healthcare seeking behavior; Musculoskeletal disorders; Nepal
Abstract: Background: Healthcare seeking behaviors among children with musculoskeletal disorders are poorly understood. We sought to analyze healthcare seeking delays among children with chronic musculoskeletal conditions in Nepal and identify predictors of clinically significant delays.

Methods: A cross-sectional study was conducted at a large pediatric musculoskeletal rehabilitation center in Nepal. Baseline sociodemographic data and healthcare seeking behaviors were assessed via interviews with 75 randomly selected caregivers. Delays of at least 3 months between disease recognition and presentation to a health worker were considered clinically significant. Predictors of significant delay were assessed via multivariable logistic regression.

Results: Clubfoot was the most common condition seen in the study sample (N = 33; 37%). Mean and median presentation delays were 33 months and 14 months, respectively. Sixty-seven percent of children were delayed at least 3 months and 40% were delayed at least 2 years. Caregiver occupation in agriculture or unskilled labor was associated with an increased risk of delayed presentation (adjusted OR = 4.05; 95% CI: 1.36–12.09).

Conclusions: Children with chronic musculoskeletal disorders in Nepal face significant delays in accessing healthcare. This poses a major clinical problem as the delayed diagnosis and treatment of childhood musculoskeletal disorders can complicate management options and decrease long-term quality of life.
Open Access: This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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Journal: Journal of Epidemiology and Global Health
Volume-Issue: 7 - 4
Pages: 299 - 304
Publication Date: 2017/10/12
ISSN (Online): 2210-6014
ISSN (Print): 2210-6006
DOI: 10.1016/j.jegh.2017.10.002 How to use a DOI?
Open Access: This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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ris enw bib

TY  - JOUR
AU  - Drake G. LeBrun
AU  - Divya Talwar
AU  - Tuyetnhi A. Pham
AU  - Bibek Banskota
AU  - David A. Spiegel
PY  - 2017
DA  - 2017/10/12
TI  - Predictors of healthcare seeking delays among children with chronic musculoskeletal disorders in Nepal
JO  - Journal of Epidemiology and Global Health
SP  - 299
EP  - 304
VL  - 7
IS  - 4
SN  - 2210-6014
UR  - https://doi.org/10.1016/j.jegh.2017.10.002
DO  - 10.1016/j.jegh.2017.10.002
ID  - LeBrun2017
ER  -

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