Management of hematogenous osteomyelitis in children in Douala, Cameroon: diagnostic challenges, complications, and perspectives for improvement

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: < 0.20 were entered into a multivariable logistic regression model to identify independent predictors of unfavorable outcome. Results: 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.