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

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-sec...

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Main Authors: Drake G. LeBrun, Divya Talwar, Tuyetnhi A. Pham, Bibek Banskota, David A. Spiegel
Format: Article
Language:English
Published: Springer 2019-04-01
Series:Journal of Epidemiology and Global Health
Subjects:
Online Access:https://www.atlantis-press.com/article/125905841/view
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author Drake G. LeBrun
Divya Talwar
Tuyetnhi A. Pham
Bibek Banskota
David A. Spiegel
author_facet Drake G. LeBrun
Divya Talwar
Tuyetnhi A. Pham
Bibek Banskota
David A. Spiegel
author_sort Drake G. LeBrun
collection DOAJ
description 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.
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spelling doaj.art-65eb0f26aeec480c8426f7da6b8c2ae62022-12-22T00:49:34ZengSpringerJournal of Epidemiology and Global Health2210-60062019-04-017410.1016/j.jegh.2017.10.002Predictors of healthcare seeking delays among children with chronic musculoskeletal disorders in NepalDrake G. LeBrunDivya TalwarTuyetnhi A. PhamBibek BanskotaDavid A. SpiegelBackground: 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.https://www.atlantis-press.com/article/125905841/viewHealthcare seeking behaviorMusculoskeletal disordersNepal
spellingShingle Drake G. LeBrun
Divya Talwar
Tuyetnhi A. Pham
Bibek Banskota
David A. Spiegel
Predictors of healthcare seeking delays among children with chronic musculoskeletal disorders in Nepal
Journal of Epidemiology and Global Health
Healthcare seeking behavior
Musculoskeletal disorders
Nepal
title Predictors of healthcare seeking delays among children with chronic musculoskeletal disorders in Nepal
title_full Predictors of healthcare seeking delays among children with chronic musculoskeletal disorders in Nepal
title_fullStr Predictors of healthcare seeking delays among children with chronic musculoskeletal disorders in Nepal
title_full_unstemmed Predictors of healthcare seeking delays among children with chronic musculoskeletal disorders in Nepal
title_short Predictors of healthcare seeking delays among children with chronic musculoskeletal disorders in Nepal
title_sort predictors of healthcare seeking delays among children with chronic musculoskeletal disorders in nepal
topic Healthcare seeking behavior
Musculoskeletal disorders
Nepal
url https://www.atlantis-press.com/article/125905841/view
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