Developing and implementing an intervention model for chronic osteomyelitis prevention in rural Rwanda through early detection of osteomyelitis at community and primary healthcare levels and evaluating the impact of the model.
Osteomyelitis, a bacterial infection of bone and bone marrow, frequently affects children and adolescents in underdeveloped regions. Without prompt diagnosis and treatment, it can rapidly become chronic, leading to severe health and socioeconomic consequences. A pilot project in Rwanda’s Nyamasheke...
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| Format: | Doctoral Thesis |
| Language: | English |
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Philipps-Universität Marburg
2025
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| Online Access: | PDF Full Text |
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| Summary: | Osteomyelitis, a bacterial infection of bone and bone marrow, frequently affects children and adolescents in underdeveloped regions. Without prompt diagnosis and treatment, it can rapidly become chronic, leading to severe health and socioeconomic consequences.
A pilot project in Rwanda’s Nyamasheke District aimed to reduce the progression to chronic osteomyelitis through a prevention program.
In Phase I of the Public Health Project it was found that 28% of surgeries were due to osteomyelitis, with 86.9% of these being for chronic cases. Contributing factors included lack of knowledge, lack of disease awareness, inadequate collaboration among health facilities. Additionally, over 40% of patients sought treatment from traditional healers.
Phase II involved developing a comprehensive training program to enhance knowledge about osteomyelitis, raise public awareness, and improve cooperation among healthcare providers. Between April 2021 and November 2023, approximately 2,300 Community Health Workers and staff from all 20 Health Centers and the two district Hospitals were trained to recognize early symptoms of acute osteomyelitis and promptly refer affected children to hospitals
Phase III focused on data analysis. It turned out that the primary goal of the project had been achieved. In comparison with the analysis from Phase I, the rate of chronic osteomyelitis in the Nyamasheke District was reduced from 87,9% to 41.3%.
The comparison of patients from the Nyamasheke District with those from the neighboring districts where Healthcare providers were not trained showed that in the Nyamasheke District with trained healthcare providers, osteomyelitis was recognized in the acute stage in 58.7%, in the neighboring districts only in 32.1%. Accordingly, the rate of chronic osteomyelitis patients in Nyamasheke District was significantly lower at 41.3% compared to 67.9% of chronically infected patients in neighboring districts. |
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| DOI: | 10.17192/z2025.0177 |