Detection of Adolescent Idiopathic Scoliosis among Nepalese Children Through the School Screening Program

Abstract

Introduction: Idiopathic Adolescent Scoliosis (IAS) is the commonest type of scoliosis without any known cause. There has been studies in different countries and population on IAS; and its prevalence rate varies for different population. There has been no reported study done in Nepal on prevalence of adolescent idiopathic scoliosis (AIS). The aim of this study was to detect and evaluate the prevalence of idiopathic adolescent scoliosis in school children in different parts of Nepal.Methods: This was a descriptive cross sectional study conducted at Þ ve schools from different geographical parts of Nepal, from January 2010 to December 2010. Scoliosis screening was done in 5 schools from different geographical locations of Nepal. Children (from grade 6 to 10; age more than 10 years) with positive Adam's forward bending test and scoliometer angle of 5 degrees or more were subjected for radiographic evaluation of the spine. The criterion for the diagnosis of scoliosis was detection of Cobb's angle of more than 10 degrees. Evaluation of scoliosis according to the age, gender, ethnic group, spinal region and magnitude of curve was done.Results: Out of 1094 children screened, 31 (2.83%) were referred for radiological evaluation; and 12 of them had lateral spinal curvature of more than 10 degrees. Hence the prevalence of scoliosis was 1.09%. The girl to boy ratio of distribution of scoliosis was 3:1 for larger curves of more than 20 degrees. Maximum number of scoliosis cases was seen in girls of 13 years, and the right sided thoracic scoliosis was most common. There is no ethnic predominance of scoliosis. Conclusion:Prevalence of idiopathic scoliosis among school children who need treatment in Nepal is low; however, school screening program has its epidemiological value.

Epidemiological and Diagnostic Characteristics of Scoliosis in Children in a Single Tertiary Centre in Abidjan

“…The mean age and female predominance observed in this series were similar to the data of several authors. [ 6 16 24 25 26 ] The cause of the difference between the two sexes is unknown. For Fadzan and Bettany-Saltikov, these can be due to the spine architecture of girls where spines are thinner with narrower vertebral bodies than boys.…”

“…This delay in consultation also reported in Nepal by Pokharel et al . [ 6 ] is multifactorial: (a) the finding is difficult in children or adolescents constantly dressed, especially when the scoliosis is balanced or has a slight or moderate curvature; (b) parents think that the broken back of their children is voluntary and synonymous with playing smart; (c) the remoteness of health centres from specialised structures and (d) and the initial use of traditional healers and prayer houses because of the mystical-religious attributed to scoliosis by our populations. Tiaho et al .,[ 19 ] in their study done in Côte d'Ivoire, noted that 39.4% of patients had used traditional healers before the first consultation.…”

“…This result is similar to the findings of several authors. [ 3 6 8 14 30 ] For Konieczny et al . [ 30 ] in Germany, the pre-existing rotation pattern in the spine varies with age.…”

“…[ 1 2 3 ] Their prevalence varies between 2% and 3% in the general population. [ 1 4 5 6 7 8 9 10 11 ] They more frequently affect adolescent girls. [ 12 13 ] Aetiologies vary and are dominated by idiopathic causes in 75%–80% of cases.…”

A study on screening for scoliosis among school children in the age group of 10-14 using a cost effective and an innovative technique

“…However in a study done by Pokharel et al in Nepal, 50% of the positive cases had thoracic scoliotic curves. 21 Similarly, 0.2%, 0.5% and 0.3% of the children had >7 o App reading for thoracic, thoracolumbar and lumbar regions respectively with greater prevalence (50% of positive cases) of thoracolumbar scoliotic curves. The readings of the Scoliometer device and Scoliometer HD app which are therefore similar.…”