Khan H1, Abdul N1, Rubab A1, Ali F1
1Muhammad Shahbaz Shareef Hospital, Physical Rehabilitation Centre, Lahore, Pakistan
Background: WHO (2016) documents that 0.5% of a population requires access to assistive devices, which includes prosthetic care. Amputees often face significant challenges in accessing basic health and rehabilitation services that are often centralized hence not accessible to those in need (Rathore et al , 2011; Irfan, F. B. et al., 2012). Poor financial conditions and lack of service providers are some key challenges to access prosthetic care.
Purpose: Literature review indicates that no quantitative research study has previously provided empirical findings on access to prosthetic care in Lahore. The present study aims at providing a better understanding of how many amputees are seeking prosthetic care at the Indus hospital in Lahore and peripheries
Methods: A retrospective two-year survey was conducted at ICRC supported physical rehabilitation Centre (PRC) Lahore, Pakistan. For this purpose the ICRC developed database was utilized to undertake the descriptive analysis of Service Users (SU) registered with PRC Lahore. A total of (2509) amputees fulfilled the inclusion criteria out of total enrolled SUs in PRC. SUs were informed that by accessing services they agreed to have their anonymized data used for research purposes. The demographic data, etiology, associated injuries and type of prosthesis provided were documented. The data was further analyzed using SPSS 21.
Results: From 2015 till 2018 (2509) amputees, age range (15 -55 years), were registered in PRC Lahore, Pakistan. Out of which 88% (2224) male and 12% (285) female. Also, 65% (1027) had Road accident, 24% (389) diabetes leading to gangrene, 5% (88) tumor and 5% (77) had mechanical injuries. Remaining 1% causes are miscellaneous. Among them 769 are provided with Prosthetic devices out of which 49% with TTP, 45% with TFP while remaining 6% were other devices. An alarming number of 1,740 lower limb amputees is still on waiting list.
Conclusion(s): The above mentioned findings are suggestive of a major need of rehabilitative services. PRC Lahore was ideally established as a district PRC however due to lack of availability of free of cost quality services, SUs from all over peripheral districts are also approaching here. Road traffic accident (RTA) ratio was 46% in 2016 which increased upto 58% in 2017, ratio of diabetes was 18% in 2016 and 16% in 2017, whereas tumor is now replaced by mechanical injury as a 3rd leading cause as the %age rose from 0.5% in 2016 to 4.5% in 2017. The ratio of women seeking P&O services is alarmingly less causes need to be found out.The ratio of women seeking P&O services is alarmingly less causes need to be found out.
Implications: Ideally there should be physical rehabilitation Centre in every district for patients which will reduce the burden on PRC Lahore. Additionally the HR and space for the existing Centre should be increased to cope increasing demands of need of rehab services from Lahore being the 2nd largest city of Pakistan with population of 11.1 million.Possible reasons for less ratio of female SU are society norms,gender barrier, lack of social support from family, financial restraints, and lack of accommodation facility within Centre.
Keywords: Lower limb amputation, Leading causes, Demography
Funding acknowledgements: The author would like to thank the International Committee of Red Cross(ICRC) for providing technical support
Purpose: Literature review indicates that no quantitative research study has previously provided empirical findings on access to prosthetic care in Lahore. The present study aims at providing a better understanding of how many amputees are seeking prosthetic care at the Indus hospital in Lahore and peripheries
Methods: A retrospective two-year survey was conducted at ICRC supported physical rehabilitation Centre (PRC) Lahore, Pakistan. For this purpose the ICRC developed database was utilized to undertake the descriptive analysis of Service Users (SU) registered with PRC Lahore. A total of (2509) amputees fulfilled the inclusion criteria out of total enrolled SUs in PRC. SUs were informed that by accessing services they agreed to have their anonymized data used for research purposes. The demographic data, etiology, associated injuries and type of prosthesis provided were documented. The data was further analyzed using SPSS 21.
Results: From 2015 till 2018 (2509) amputees, age range (15 -55 years), were registered in PRC Lahore, Pakistan. Out of which 88% (2224) male and 12% (285) female. Also, 65% (1027) had Road accident, 24% (389) diabetes leading to gangrene, 5% (88) tumor and 5% (77) had mechanical injuries. Remaining 1% causes are miscellaneous. Among them 769 are provided with Prosthetic devices out of which 49% with TTP, 45% with TFP while remaining 6% were other devices. An alarming number of 1,740 lower limb amputees is still on waiting list.
Conclusion(s): The above mentioned findings are suggestive of a major need of rehabilitative services. PRC Lahore was ideally established as a district PRC however due to lack of availability of free of cost quality services, SUs from all over peripheral districts are also approaching here. Road traffic accident (RTA) ratio was 46% in 2016 which increased upto 58% in 2017, ratio of diabetes was 18% in 2016 and 16% in 2017, whereas tumor is now replaced by mechanical injury as a 3rd leading cause as the %age rose from 0.5% in 2016 to 4.5% in 2017. The ratio of women seeking P&O services is alarmingly less causes need to be found out.The ratio of women seeking P&O services is alarmingly less causes need to be found out.
Implications: Ideally there should be physical rehabilitation Centre in every district for patients which will reduce the burden on PRC Lahore. Additionally the HR and space for the existing Centre should be increased to cope increasing demands of need of rehab services from Lahore being the 2nd largest city of Pakistan with population of 11.1 million.Possible reasons for less ratio of female SU are society norms,gender barrier, lack of social support from family, financial restraints, and lack of accommodation facility within Centre.
Keywords: Lower limb amputation, Leading causes, Demography
Funding acknowledgements: The author would like to thank the International Committee of Red Cross(ICRC) for providing technical support
Topic: Disability & rehabilitation
Ethics approval required: Yes
Institution: Muhammad Shahbaz Sharif Hospital (Indus) Lahore
Ethics committee: IRD-IRB (Interactive Research and Development-Institutional review Board)
Ethics number: (IRD_IRB_2018_07_011)
All authors, affiliations and abstracts have been published as submitted.
