Delayed consultation and sickle cell disease associated with poor outcomes in pediatric osteomyelitis in Cameroon

This retrospective cross-sectional cohort study examined management, diagnostic challenges, complications, and perspectives for improvement of pediatric hematogenous osteomyelitis. The population included children aged 0–15 years diagnosed with hematogenous osteomyelitis at five referral hospitals in Douala, Cameroon, between 2017 and 2024. The specific intervention or exposure studied was not reported, and no comparator was specified.

The main results showed multiple associations with adverse outcomes. Delayed consultation and sickle cell disease were identified as major determinants of poor outcomes. Specific associations included chronic osteomyelitis (aOR 4.54), functional impairment (aOR 2.99), abnormal ultrasound findings (aOR 3.69), prolonged antibiotic therapy >3 months (aOR 14.88), symptom duration >3 months (aOR 19.65), previous osteomyelitis (aOR 15.08), and sickle cell disease (aOR 7.18). Absolute numbers, p-values, and confidence intervals were not reported for these associations.

Safety and tolerability data were not reported. The study was observational and retrospective in design, using univariate analysis with odds ratios and adjusted odds ratios reported for some variables. Key limitations include the inability to infer causation from associations, limited generalizability beyond Douala referral hospitals, and the absence of absolute numbers or event rates. The authors suggest early diagnosis, strengthened microbiological capacity, and multidisciplinary management are essential to improve outcomes, but these practice implications should be considered within the study's methodological constraints.