In February, Daily Monitor published an article about a 13-year-old girl suffering from Osteomyelitis, living in Mbale District.
There are many children with the same condition but unfortunately, most of them do not get early access to medical care hence their conditions worsen and lead to disability.
Tackling this problem means we have to first understand what osteomyelitis is and why people are not seeking early treatment.
Osteomyelitis is an infection of the bone or bone marrow and can occur in infants, children and adults.
Any bone may be involved but it is common in the leg bones followed by the thigh bone and then upper extremity bones. It is commonly known as Etalo in Luganda and in many cultures, it is believed to be witchcraft, meaning the victim must have jumped, stepped on or walked over charms.
Osteomyelitis can manifest in varying ways. In children, there may be pain or tenderness over the affected bone, and they may have difficulty or inability to use the affected body part or walk due to severe pain, fever, swelling and shiny skin or redness. Symptoms may be gradual in adults.
In cases of acute osteomyelitis, the occurrence is rapid, usually accompanied by pain, fever and stiffness. On the other hand, chronic osteomyelitis have less symptoms. There might not be fever, pain or swelling.
It might present with pus discharge from the affected area, skin breakdown, ulcers, or wounds that might not heal. Osteomyelitis can be mistaken for trauma or injury, especially in children, or malaria, as it is among the commonest causes of fever.
What causes osteomyelitis?
There are different ways bones can be infected but the commonest is bacteria travelling in the blood stream, spreading to the bone, the common primary sites being respiratory infections, dental infections or urinary tract infections.
An open wound can be a focus of infection. Patients with conditions or taking medications that weaken their immune system are at a higher risk of developing osteomyelitis.
Several blood tests help diagnose osteomyelitis and imaging studies like X-rays, bone scans, CT scans, MRIs, and ultrasounds may also be obtained of the involved bones. These can help identify changes in the bones that occur with osteomyelitis. In many cases, osteomyelitis can be effectively treated with antibiotics and pain medications.
If a biopsy is obtained, this can help guide the choice of the best antibiotic. The duration of treatment of osteomyelitis with antibiotics varies with the type of infection and the response to the treatments. But sometimes, surgery may be necessary.
If there is an area of localised bacteria (bone abscess), this may need to be opened, washed out, and drained. If there is damaged soft tissue or bone, this may need to be removed and it may need to be replaced with bone graft or stabilised during surgery.
Traditionally, modern medical interventions are strongly discouraged and believed to be fatal and for this matter, patients/parents opt for herbs and rituals.
This contradicts the facts about osteomyelitis as early diagnosis and appropriate treatment gives the best outcome and patients can make a full recovery without long-standing complications.
However, if there is a long delay in diagnosis or treatment, or if there is significant bone and soft tissue injury due to trauma with compromised local blood supply, it can lead to permanent functional deficits and/or make the patient more prone to recurrence and in the unfortunate event, it may lead to loss of a limb.
Dr Nyiiro is an orthopaedic surgeon at CoRSU Hospital in Kisubi, Entebbe Road. firstname.lastname@example.org