Published in PLOS One on 2026-03-20, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Reta Wakoya, Mekbeb Afework, Alemayehu Worku, Firaol Dandena, Stefano Bolongaro, Timothy Nunn
Source: PLOS One • DOI 10.1371/journal.pone.0344671
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Scoliosis is a progressive spinal deformity that often develops during childhood and adolescence. In Ethiopia, population-level prevalence data are scarce, and school-based screening, though practical, may overestimate cases without radiographic confirmation. Understanding its distribution and severity is critical for guiding clinical and public health strategies.
To estimate the prevalence of scoliosis among Ethiopian schoolchildren, characterize its types and severity, and examine associations with clinical and anthropometric variables.
A cross-sectional school-based screening was conducted from March 2024 to June 2025 across 42 public primary schools in six regions. Children aged 6–15 years were screened using the Adam’s Forward Bend Test and scoliometer; suspected cases (ATR ≥ 7°) were referred for radiographic confirmation. Prevalence estimates and associations were analyzed using chi-square tests and t-tests. Data were analyzed in Python, with quality control ensured through standardized training, pilot testing, and double-entry verification.
Of 32,000 children screened, 48 were suspected of scoliosis (0.15%; 95% CI: 0.11–0.20%), and 21 were radiographically confirmed (0.066%; 95% CI: 0.04–0.10%). Congenital scoliosis was most common (61.9%), with male predominance (69%), while idiopathic scoliosis (23.8%) was more frequent in females (60%). Neuromuscular and syndromic scoliosis were rare. Severity analysis showed male predominance in mild and very severe cases, with equal sex distribution in severe scoliosis. The mean Cobb angle was 47.4° (SD ± 28.9), most cases involved the thoracic spine (52.4%), and the rib hump was typically right-sided (61.9%). Cobb angle correlated positively with ATR (r = 0.61) and thoracic loss (r = 0.48), and negatively with age (r = –0.24) and thoracic height (r = –0.46).
This study shows that scoliosis prevalence within the school population is low, with adolescent idiopathic cases markedly underrepresented compared to other school-based screening reports. These findings suggest that nationwide school screening programs are not recommended. Instead, efforts should prioritize strengthening diagnostic and referral pathways for clinically evident cases to ensure timely access to specialized care.
1. Background
Scoliosis is a structural spinal deformity characterized by a lateral curvature exceeding 10°, typically accompanied by vertebral rotation and rib cage asymmetry [1,2]. Etiologically, scoliosis is classified as congenital, neuromuscular, and idiopathic, with idiopathic scoliosis comprising approximately 85% of cases [3]. Idiopathic scoliosis is further subdivided based on age of onset into infantile (0–3 years), juvenile (4–9 years), and adolescent (≥10 years), with adolescent idiopathic scoliosis being the most prevalent subtype in Western literature [3,4].
Early detection of scoliosis is vital for minimizing complications and optimizing outcomes. Timely identification enables non-invasive interventions, such as bracing, to halt curve progression during growth, reducing surgical need [5]. Prompt management improves physical comfort, posture, and quality of life, reinforcing the importance of effective screening and early therapeutic support for long-term success [6]. School-based scoliosis screening programs potentially offer an effective strategy for early detection and timely intervention, particularly during critical growth phases [7]. These initiatives not only facilitate early management to prevent curve progression but also enhance spinal health awareness among students, families, and educators, promoting proactive care [8].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider technology & industry desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Reta Wakoya, Mekbeb Afework, Alemayehu Worku, Firaol Dandena, Stefano Bolongaro, Timothy Nunn. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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