Musculoskeletal impairment survey in Rwanda: Design of survey tool, survey methodology, and results of the pilot study (a cross sectional survey)
Identifieur interne : 001B26 ( Pmc/Curation ); précédent : 001B25; suivant : 001B27Musculoskeletal 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
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Hannah Kuper<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>
<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>
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<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>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Musculoskelet Disord</journal-id>
<journal-title>BMC Musculoskeletal Disorders</journal-title>
<issn pub-type="epub">1471-2474</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
<publisher-loc>London</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">17391509</article-id>
<article-id pub-id-type="pmc">1852555</article-id>
<article-id pub-id-type="publisher-id">1471-2474-8-30</article-id>
<article-id pub-id-type="doi">10.1186/1471-2474-8-30</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Musculoskeletal impairment survey in Rwanda: Design of survey tool, survey methodology, and results of the pilot study (a cross sectional survey)</article-title>
</title-group>
<contrib-group><contrib id="A1" corresp="yes" contrib-type="author"><name><surname>Atijosan</surname>
<given-names>Oluwarantimi</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>o.atijosan@nhs.net</email>
</contrib>
<contrib id="A2" contrib-type="author"><name><surname>Kuper</surname>
<given-names>Hannah</given-names>
</name>
<xref ref-type="aff" rid="I2">2</xref>
<email>hannnah.kuper@lshtm.ac.uk</email>
</contrib>
<contrib id="A3" contrib-type="author"><name><surname>Rischewski</surname>
<given-names>Dorothea</given-names>
</name>
<xref ref-type="aff" rid="I2">2</xref>
<email>dorothea.rischewski@lshtm.ac.uk</email>
</contrib>
<contrib id="A4" contrib-type="author"><name><surname>Simms</surname>
<given-names>Victoria</given-names>
</name>
<xref ref-type="aff" rid="I3">3</xref>
<email>vickysimms@msn.com</email>
</contrib>
<contrib id="A5" contrib-type="author"><name><surname>Lavy</surname>
<given-names>Christopher</given-names>
</name>
<xref ref-type="aff" rid="I4">4</xref>
<email>christopher.lavy@ndos.ox.ac.uk</email>
</contrib>
</contrib-group>
<aff id="I1"><label>1</label>
Trauma Unit, John Radcliffe Hospital, Oxford, OX3 9DU, UK.</aff>
<aff id="I2"><label>2</label>
International Centre Of Eye Health, London School Of Hygiene & Tropical Medicine, Keppel Street, WC1E 7HT London. UK.</aff>
<aff id="I3"><label>3</label>
Palliative Care, Policy and Rehabilitation, King's College London, London SE5 9RJ, UK.</aff>
<aff id="I4"><label>4</label>
Nuffield Department of Orthopaedic Surgery, University Of Oxford, Windmill Road, Oxford OX3 7LD, UK.</aff>
<pub-date pub-type="collection"><year>2007</year>
</pub-date>
<pub-date pub-type="epub"><day>28</day>
<month>3</month>
<year>2007</year>
</pub-date>
<volume>8</volume>
<fpage>30</fpage>
<lpage>30</lpage>
<ext-link ext-link-type="uri" xlink:href="http://www.biomedcentral.com/1471-2474/8/30"></ext-link>
<history><date date-type="received"><day>9</day>
<month>8</month>
<year>2006</year>
</date>
<date date-type="accepted"><day>28</day>
<month>3</month>
<year>2007</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2007 Atijosan et al; licensee BioMed Central Ltd.</copyright-statement>
<copyright-year>2007</copyright-year>
<copyright-holder>Atijosan et al; licensee BioMed Central Ltd.</copyright-holder>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0"><p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0"></ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p>
<pmc-comment>
Atijosan
Oluwarantimi
o.atijosan@nhs.net
Musculoskeletal impairment survey in Rwanda: Design of survey tool, survey methodology, and results of the pilot study (a cross sectional survey)
2007 BMC Musculoskeletal Disorders 8(1): 30-. (2007) 1471-2474(2007)8:1<30> urn:ISSN:1471-2474 </pmc-comment>
</license>
</permissions>
<abstract><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>
</abstract>
</article-meta>
</front>
</pmc>
</record>
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