ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Orthopedics
MANAGEMENT OF HEMATOGENOUS OSTEOMYELITIS IN CHILDREN IN DOUALA, CAMEROON: DIAGNOSTIC CHALLENGES, COMPLICATIONS, AND PERSPECTIVES FOR IMPROVEMENT
Provisionally accepted
Pauline MANTHO FOPA1,2*
Prosper Mouapi1Eric BITCHOKA2Faustin MOUAFO3Frederique AZO'O4Theophile Kamguep5Jean Paul Engbang1Puis FOKAM6- 1Faculty of Medicine and Pharmaceutical Science, University of Douala, Douala, Cameroon
- 2Hopital Laquintinie de Duoala, Douala, Cameroon
- 3Universite de Yaounde I Faculte de Medecine et des Sciences Biomedicales, Yaoundé, Cameroon
- 4Hospital gyneco-obstetric and pediatrique of Douala, Douala, Cameroon
- 5Protestant Hospital of Ndogbati , Douala, Douala, Cameroon
- 6University of Buea, Buea, Cameroon
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Background: Pediatric hematogenous osteomyelitis remains a major cause of morbidity in low-resource settings. In Douala, Cameroon, delayed diagnosis and comorbid conditions contribute to severe disease and unfavorable outcomes. Methods: We conducted a retrospective cross-sectional study of children aged 0–15 years diagnosed with hematogenous osteomyelitis in five referral hospitals in Douala between January 2017 and December 2024. Sociodemographic, clinical, microbiological, therapeutic, and outcome data were collected. Univariate analysis was performed using odds ratios (OR) with 95% confidence intervals (CI), and variables with p < 0.20 were entered into a multivariable logistic regression model to identify independent predictors of unfavorable outcome. Results: Among 306 pediatric osteoarticular infections, 102 were osteomyelitis and 81 met inclusion criteria. The mean age was 6.88 ± 3.98 years, with male predominance (sex ratio 1.79). Consultation was delayed beyond three months in 48.1% of cases. Blood cultures were positive in 21.6%, while focal cultures were positive in 71.1%, with Staphylococcus aureus as the predominant pathogen. Sickle cell disease (SS genotype) was identified in 25.9% of the cohort. Surgical management was required in 46.9% of patients, mainly in chronic forms. Complications occurred in 25.9% of cases. Independent predictors of unfavorable outcome included consultation delay >3 months (aOR 19.65), previous osteomyelitis (aOR 15.08), sickle cell disease (aOR 7.18), chronic osteomyelitis (aOR 4.54), functional impairment (aOR 2.99), abnormal ultrasound findings (aOR 3.69), and prolonged antibiotic therapy >3 months (aOR 14.88). Conclusion: Pediatric hematogenous osteomyelitis in Douala remains frequent and severe. Delayed consultation and sickle cell disease are major determinants of poor prognosis. Early diagnosis, strengthened microbiological capacity, and multidisciplinary management are essential to improve outcomes.
Keywords: hematogenous infection, Pediatric osteomyelitis, prognostic factors, Sickle Cell Disease, surgical management
Received: 30 Dec 2025; Accepted: 16 Feb 2026.
Copyright: © 2026 MANTHO FOPA, Mouapi, BITCHOKA, MOUAFO, AZO'O, Kamguep, Engbang and FOKAM. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Pauline MANTHO FOPA
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