Musculoskeletal impairment survey in Rwanda: Design of survey tool, survey methodology, and results of the pilot study (a cross sectional survey)
Identifieur interne : 007184 ( Main/Exploration ); précédent : 007183; suivant : 007185Musculoskeletal impairment survey in Rwanda: Design of survey tool, survey methodology, and results of the pilot study (a cross sectional survey)
Auteurs : Oluwarantimi Atijosan [Royaume-Uni] ; Hannah Kuper ; Dorothea Rischewski ; Victoria Simms [Royaume-Uni] ; Christopher Lavy [Royaume-Uni]Source :
- BMC Musculoskeletal Disorders [ 1471-2474 ] ; 2007.
Abstract
Musculoskeletal impairment (MSI) is an important cause of morbidity and mortality worldwide, especially in developing countries. Prevalence studies for MSI in the developing world have used varying methodologies and are seldom directly comparable. This study aimed to develop a new tool to screen for and diagnose MSI and to pilot test the methodology for a national survey in Rwanda.
A 7 question screening tool to identify cases of MSI was developed through literature review and discussions with healthcare professionals. To validate the tool, trained rehabilitation technicians screened 93 previously identified gold standard 'cases' and 86 'non cases'. Sensitivity, specificity and positive predictive value were calculated. A standardised examination protocol was developed to determine the aetiology and diagnosis of MSI for those who fail the screening test. For the national survey in Rwanda, multistage cluster random sampling, with probability proportional to size procedures will be used for selection of a cross-sectional, nationally representative sample of the population. Households to be surveyed will be chosen through compact segment sampling and all individuals within chosen households will be screened. A pilot survey of 680 individuals was conducted using the protocol.
The screening tool demonstrated 99% sensitivity and 97% specificity for MSI, and a positive predictive value of 98%. During the pilot study 468 out of 680 eligible subjects (69%) were screened. 45 diagnoses were identified in 38 persons who were cases of MSI. The subjects were grouped into categories based on diagnostic subgroups of congenital (1), traumatic (17), infective (2) neurological (6) and other acquired(19). They were also separated into mild (42.1%), moderate (42.1%) and severe (15.8%) cases, using an operational definition derived from the World Health Organisation's International Classification of Functioning, Disability and Health.
The screening tool had good sensitivity and specificity and was appropriate for use in a national survey. The pilot study showed that the survey protocol was appropriate for measuring the prevalence of MSI in Rwanda. This survey is an important step to building a sound epidemiological understanding of MSI, to enable appropriate health service planning.
Url:
DOI: 10.1186/1471-2474-8-30
PubMed: 17391509
PubMed Central: 1852555
Affiliations:
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UK.</nlm:aff><wicri:noCountry code="subfield">WC1E 7HT London. UK.</wicri:noCountry></affiliation></author><author><name sortKey="Rischewski, Dorothea" sort="Rischewski, Dorothea" uniqKey="Rischewski D" first="Dorothea" last="Rischewski">Dorothea Rischewski</name><affiliation><nlm:aff id="I2">International Centre Of Eye Health, London School Of Hygiene & Tropical Medicine, Keppel Street, WC1E 7HT London. UK.</nlm:aff><wicri:noCountry code="subfield">WC1E 7HT London. UK.</wicri:noCountry></affiliation></author><author><name sortKey="Simms, Victoria" sort="Simms, Victoria" uniqKey="Simms V" first="Victoria" last="Simms">Victoria Simms</name><affiliation wicri:level="1"><nlm:aff id="I3">Palliative Care, Policy and Rehabilitation, King's College London, London SE5 9RJ, UK.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Royaume-Uni</country><wicri:regionArea>Palliative Care, Policy and Rehabilitation, King's College London, London SE5 9RJ</wicri:regionArea><wicri:noRegion>London SE5 9RJ</wicri:noRegion></affiliation></author><author><name sortKey="Lavy, Christopher" sort="Lavy, Christopher" uniqKey="Lavy C" first="Christopher" last="Lavy">Christopher Lavy</name><affiliation wicri:level="4"><nlm:aff id="I4">Nuffield Department of Orthopaedic Surgery, University Of Oxford, Windmill Road, Oxford OX3 7LD, UK.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Royaume-Uni</country><wicri:regionArea>Nuffield Department of Orthopaedic Surgery, University Of Oxford, Windmill Road, Oxford OX3 7LD</wicri:regionArea><orgName type="university">Université d'Oxford</orgName><placeName><settlement type="city">Oxford</settlement><region type="nation">Angleterre</region><region type="région" nuts="1">Oxfordshire</region></placeName></affiliation></author></analytic><series><title level="j">BMC Musculoskeletal Disorders</title><idno type="eISSN">1471-2474</idno><imprint><date when="2007">2007</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Musculoskeletal impairment (MSI) is an important cause of morbidity and mortality worldwide, especially in developing countries. Prevalence studies for MSI in the developing world have used varying methodologies and are seldom directly comparable. This study aimed to develop a new tool to screen for and diagnose MSI and to pilot test the methodology for a national survey in Rwanda.</p></sec><sec sec-type="methods"><title>Methods</title><p>A 7 question screening tool to identify cases of MSI was developed through literature review and discussions with healthcare professionals. To validate the tool, trained rehabilitation technicians screened 93 previously identified gold standard 'cases' and 86 'non cases'. Sensitivity, specificity and positive predictive value were calculated. A standardised examination protocol was developed to determine the aetiology and diagnosis of MSI for those who fail the screening test. For the national survey in Rwanda, multistage cluster random sampling, with probability proportional to size procedures will be used for selection of a cross-sectional, nationally representative sample of the population. Households to be surveyed will be chosen through compact segment sampling and all individuals within chosen households will be screened. A pilot survey of 680 individuals was conducted using the protocol.</p></sec><sec><title>Results:</title><p>The screening tool demonstrated 99% sensitivity and 97% specificity for MSI, and a positive predictive value of 98%. During the pilot study 468 out of 680 eligible subjects (69%) were screened. 45 diagnoses were identified in 38 persons who were cases of MSI. The subjects were grouped into categories based on diagnostic subgroups of congenital (1), traumatic (17), infective (2) neurological (6) and other acquired(19). They were also separated into mild (42.1%), moderate (42.1%) and severe (15.8%) cases, using an operational definition derived from the World Health Organisation's International Classification of Functioning, Disability and Health.</p></sec><sec><title>Conclusion:</title><p>The screening tool had good sensitivity and specificity and was appropriate for use in a national survey. The pilot study showed that the survey protocol was appropriate for measuring the prevalence of MSI in Rwanda. This survey is an important step to building a sound epidemiological understanding of MSI, to enable appropriate health service planning.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Oxfordshire</li></region><settlement><li>Oxford</li></settlement><orgName><li>Université d'Oxford</li></orgName></list><tree><noCountry><name sortKey="Kuper, Hannah" sort="Kuper, Hannah" uniqKey="Kuper H" first="Hannah" last="Kuper">Hannah Kuper</name><name sortKey="Rischewski, Dorothea" sort="Rischewski, Dorothea" uniqKey="Rischewski D" first="Dorothea" last="Rischewski">Dorothea Rischewski</name></noCountry><country name="Royaume-Uni"><noRegion><name sortKey="Atijosan, Oluwarantimi" sort="Atijosan, Oluwarantimi" uniqKey="Atijosan O" first="Oluwarantimi" last="Atijosan">Oluwarantimi Atijosan</name></noRegion><name sortKey="Lavy, Christopher" sort="Lavy, Christopher" uniqKey="Lavy C" first="Christopher" last="Lavy">Christopher Lavy</name><name sortKey="Simms, Victoria" sort="Simms, Victoria" uniqKey="Simms V" first="Victoria" last="Simms">Victoria Simms</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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