Risk factors of lower limb cellulitis in a level-two healthcare facility in Cameroon: a case-control study

BMC Infectious Diseases

Research Article

Sara Saheb Kashaf¹  Eric O. Ohuma²  Tsi Njim³  Louise Daniele Toukam⁴  Valirie Ndip Agbor⁵  Leopold Ndemnge Aminde⁶ 

[1] Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Old Road Campus, University of Oxford, OX3 7BN, Oxford, UK;Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Old Road Campus, University of Oxford, OX3 7BN, Oxford, UK;Centre for Statistics in Medicine, Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford, Windmill Road, OX3 7LD, Oxford, UK;Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Old Road Campus, University of Oxford, OX3 7BN, Oxford, UK;Health and Human Development Research Group, Douala, Cameroon;Faculty of Health Sciences, University of Bamenda, Northwest Region, Bamenda, Cameroon;Ibal sub – Divisional Hospital, Oku, Northwest Region, Oku, Cameroon;School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia;Clinical Research Education, Networking and Consultancy (CRENC), Douala, Littoral, Cameroon;

关键词: Lower limb cellulitis;    Risk factors;    Disease burden;    Cameroon;   

DOI  :  10.1186/s12879-017-2519-1

 received in 2017-04-03, accepted in 2017-06-01,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundCellulitis is a common infection of the skin and subcutaneous tissues. It is associated with significant morbidity from necrosectomies and amputations especially in sub-Saharan Africa. We aimed at identifying the risk factors and burden of lower limb cellulitis to inform preventive strategies in Cameroon.MethodsThis was a hospital–based case-control study carried out in the Bamenda Regional Hospital (BRH) between September 2015 and August 2016. Cases were defined as consenting adults admitted to the surgical unit who presented with a localised area of lower limb erythema, warmth, oedema and pain, associated with fever (temperature ≥ 38 °C) and/or chills of sudden onset. Controls were adults hospitalised for diseases other than cellulitis, necrotising fasciitis, myositis, abscess or other variants of dermo-hypodermitis. Cases and controls were matched (1:2) for age and sex.ResultsOf the 183 participants (61 cases of cellulitis and 122 controls) included in the study, the median age was 52 years [Interquartile range (IQR): 32.5–74.5]. After controlling for potential confounders, obesity [adjusted odds ratio (AOR) = 4.7, 95% CI (1.5–14.7); p = 0.009], history of skin disruption [AOR = 12.4 (3.9–39.1); p < 0.001], and presence of toe-web intertrigo [AOR = 51.4 (11.7–225.6); p < 0.001] were significantly associated with cellulitis. Median hospital stay was longer (14 days [IQR: 6–28]) in cases compared to the controls (3 days [IQR: 2–7]). Among the cases, Streptococci species were the most frequent (n = 50, 82%) isolated germ followed by staphylococci species (n = 9, 15%). Patients with cellulitis were more likely to undergo necrosectomy (OR: 21.2; 95% CI: 7.6–59.2). Toe-web intertrigo had the highest (48.9%) population attributable risk for cellulitis, followed by history of disruption of skin barrier (37.8%) and obesity (20.6%).ConclusionThis study showed a high disease burden among patients with cellulitis. While risk factors identified are similar to prior literature, this study provides a contextual evidence-base for clinicians in this region to be more aggressive in management of these risk factors to prevent disease progression and development of cellulitis.

【 授权许可】

CC BY   
© The Author(s). 2017