Musculoskeletal disorders in operator drivers in northwestern Namibia ­ associated factors and awareness

Background: Operator drivers are responsible for driving trackless heavy-duty mining or construction vehicles such as graders, dumpers, loaders, and bulldozers. They have an increased prevalence of musculoskeletal disorders (MSDs) due to the nature of their work. There is a paucity of data on MSDs and associated factors among operator drivers in Namibia. Objective: We assessed awareness of, and factors associated with, MSDs among operator drivers in the construction and mining industries in Namibia. Methods: In this cross-sectional study, questionnaires were administered to operator drivers, and managerial staff were interviewed, using a semi-structured interview guide. Data obtained were analysed using chi-square tests and binary logistic regression modelling. Results: 182 operator drivers completed the questionnaires, and 13 operator drivers' supervisors and managers were interviewed. Factors associated with MSDs were length of service for ≥ 10 years (OR 15.3, 95% CI 6.0­39.0), alcohol consumption (OR 2.8, 95% CI 1.1­6.7), lack of physical fitness activity (OR 8.8, 95% CI 3.8­20.4), and lack of awareness of MSDs (OR 3.1, 95% CI 1.3­7.3). Managerial staff were of the opinion that the operator drivers did not suffer from MSDs. Conclusion: We found health issues that are associated with MSDs among the operator drivers, impacting their general wellness and productivity. Monitoring of health and wellness of these workers by the companies is recommended. There is need to increase MSD awareness, personal protective equipment usage, ergonomics skills training, and physical fitness exercises for operator drivers. Employers are urged to adopt policies, and to design guidelines and interventions aimed at promoting occupational health and safety in this population.

Epidemiology of Open Tibia fractures presenting to a tertiary referral center in Southern Malawi: a retrospective study

Road traffic accidents in Malawi have increased in recent years resulting in a high incidence of trauma seen in the hospitals as well as a high prevalence of musculoskeletal impairment in the community. Open fractures are a common consequence of road traffic accidents, and the tibia is the most common long bone open fracture. Objective Epidemiology of open tibia fractures at the largest tertiary level hospital in Malawi and incidence of infections of open fractures managed at the institution. Methodology This was a retrospective study of consecutive open tibia fracture patients seen and admitted to Queen Elizabeth Central Hospital's (QECH) orthopedic department from 1st January 2019 to 31st December 2019. Patients with life-threatening head, chest, or abdominal injuries were excluded as management takes priority over any limb-threatening injury. Results There were 72 open tibia fractures screened, and 60 of these met our entry criteria; 6 patients did not, while 6 patient files were missing. The median age of patients was 36 years, IQR (27-44.75) with Males making up 82%(n=49) of open fractures. Most of the open tibia fractures were caused by road traffic accidents 63%(n=38), followed by assaults 18%(n=11), falls 17%(n=10), and industrial accidents 2%(n=1). 26.7% (n=16) of open tibia fractures developed an infection. We found that patients' average length of stay was 16. 9(IQR 9.5-31.25) days. Most of the injuries (68.3%, n=41) were moderate to high energy injuries being Gustilo et al. grade II and III open tibia fractures. Conclusion This study identified that open tibia fractures were common in our hospital and that were often high energy injuries requiring an extended hospital stay to manage. The infection rate noted was higher than that reported on average in lower- and middle-income countries. There is a need to do more robust prospective studies in the area to gather more information.

Begging on the Streets of Addis Ababa: an Impact of Musculoskeletal Disability

Background: This was a 2-year interventional prospective study aimed at determining the frequency and pattern of musculoskeletal disability among beggars of the streets of Addis Ababa. It was part of a continuous multidisciplinary study that was trying to assess causes of street begging and looked for ways to stop it or at least bring it to 'tolerable' proportions. This part of the study mainly focused on treatable/correctable musculoskeletal disabilities leading to begging on streets in the city. It also assessed the degree; duration and reasons for street begging and determined whether correcting treatable musculoskeletal disabilities stopped beggars from begging or not. The study setting was in Addis Ababa city; in collaboration with C.A.R.D.O.S. Ethiopia. Methods: This was an interventional prospective follow-up study on beggars of the streets of Addis Ababa who claimed musculoskeletal disability as their main cause for begging. A location in a sub city was selected for a reason of hosting the largest number of beggars. In collaboration with the local administrator a clinic was opened amidst the busy street and volunteer street beggars with musculoskeletal disability were recruited for the study. Surgical procedures were performed in 61 'patients' and were followed for two years; from April 2007-April 2009. Some beggars refused a clearly beneficial surgery Results: Our survey revealed there are 1;237 street beggars including the outskirts of 'Entoto' mountain. Nearly two-third of the street beggars were males and age ranged from a week to 90. Of the 204 beggars with musculoskeletal disability; 118 were evaluated to clearly benefit from a successful surgical procedure. The commonest diagnosis was leprosy with its complications recorded in 47 of the 204; followed by bone and joint infections; 13.2( 27/204) and complex; unclear congenital anomalies ranked third. Neglected dislocations; mal-united of non-united fractures were observed in twenty (9.8) of the street beggars. Iatrogenic cause was discovered as a cause of disability in six beggars. Sixty one beggars were operated. The ages for operated cases ranged from 12 to 78 years. The duration of begging in beggars selected for surgery was from 4.5 to 56 years. Corrective amputation; Bone grafting and Sequestrectomy were the commonest procedures in respected order. One patient died due to concomitant cardiac illness. From the whole group 68 patients went back to begging while from the operated group only a single patient recently was found begging in one of the streets in Addis. Conclusion: Musculoskeletal disability may lead to begging. Well-funded; multi-sectoral long-term campaign on begging will possibly reduce it to a 'tolerable' level