Characterisation of persons with lower limb amputation who attended a tertiary rehabilitation centre in Bangladesh

Abstract

Objective: We aimed to describe the causes, types, and consequences of lower limb amputation and the demographics of subjects with such amputation who attended a tertiary rehabilitation center in Bangladesh, Centre for the Rehabilitation of the Paralysed.

Methods: Cross-sectional data were collected from subjects with lower limb amputation who attended a specialized rehabilitation center between January 2014 and August 2016. Telephone interviews were conducted using a structured questionnaire. Descriptive analysis, paired t-test, and Fisher’s exact test were conducted as well as a regression analysis was performed.

Results: A total of 332 respondents, aged 5 to 76 years (mean 37.5± SD 13.8), with lower limb amputation participated in the study. Of the respondents, the majority were male (87.7%) and lived in rural areas (64.8%). Road traffic accidents were the leading cause (58.7%) of amputation followed by peripheral vascular diseases (7.5%) and hit by sharp objects (7.2%). Age (odds ratio: 0.9) and driving as occupation (odds ratio: 7.3) were found to be statistically significant covariates for amputation from road traffic accidents. The mean duration between having an amputation and receiving the first prosthetic fitting was 6.4 years (±8.9). Among the study participants, 30.7% lost their jobs after amputation and their mean monthly income reduced significantly (p < 0.01) from US$119.9 (±421.5) to US$45.8 (±63.1).

Conclusion: Majority of the lower limb amputations resulted from traumatic road traffic accidents. Younger males and drivers were found to be more prone to amputation from road traffic accidents. Lower limb amputation creates great health and economic disparity in the amputee's lives.

Implications for rehabilitation

• Majority of the lower limb amputation cases in Bangladesh were attributable to road traffic accidents—a largely preventable cause.

• The mean time between amputation and prosthetic fitting was more than 6 years which implies lack of awareness and inaccessibility of prosthetic management.

• Policymakers, regulators, law enforcement, and traffic safety advocates should take urgent actions to prevent road traffic accidents and raise awareness about and improve availability of prosthetic rehabilitation in Bangladesh.

Keywords:

• Lower limb amputation
• amputation
• prosthetics
• road traffic accidents
• Bangladesh

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Acknowledgement

Heartiest gratitude to Mohammad Zulkar Naine, Rubayet Shafeen, Tahera Siddika, Nahidul Islam, Rifatur Rahman Robin, Nasim Mahmud and Abid Hasan Khan for their support in data collection and data input.

Disclosure statement

No potential conflict of interest was reported by the authors.