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      Epidemiology and demographics of juvenile idiopathic arthritis in Africa and Middle East

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          Abstract

          Juvenile Idiopathic Arthritis (JIA) is a group of chronic heterogenous disorders that manifests as joint inflammation in patients aged <16 years. Globally, approximately 3 million children and young adults are suffering from JIA with prevalence rates consistently higher in girls. The region of Africa and Middle East constitute a diverse group of ethnicities, socioeconomic conditions, and climates which influence the prevalence of JIA. There are only a few studies published on epidemiology of JIA in the region. There is an evident paucity of adequate and latest data from the region. This review summarizes the available data on the prevalence of JIA and its subtypes in Africa and Middle East and discusses unmet needs for patients in this region. A total of 8 journal publications were identified concerning epidemiology and 42 articles describing JIA subtypes from Africa and Middle East were included. The prevalence of JIA in Africa and Middle East was observed to be towards the lower range of the global estimate. We observed that the most prevalent subtype in the region was oligoarticular arthritis. The incidence of uveitis and anti-nuclear antibody (ANA) positivity were found to be lower as compared to the incidence from other regions. There is a huge unmet medical need in the region for reliable epidemiological data, disease awareness, having regional and local treatment guidelines and timely diagnosis. Paucity of the pediatric rheumatologists and economic disparities also contribute to the challenges regarding the management of JIA.

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          Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement.

          Damian Hoy, Peter Brooks, Anthony Woolf … (2012)
          In the course of performing systematic reviews on the prevalence of low back and neck pain, we required a tool to assess the risk of study bias. Our objectives were to (1) modify an existing checklist and (2) test the final tool for interrater agreement. The final tool consists of 10 items addressing four domains of bias plus a summary risk of bias assessment. Two researchers tested the interrater agreement of the tool by independently assessing 54 randomly selected studies. Interrater agreement overall and for each individual item was assessed using the proportion of agreement and Kappa statistic. Raters found the tool easy to use, and there was high interrater agreement: overall agreement was 91% and the Kappa statistic was 0.82 (95% confidence interval: 0.76, 0.86). Agreement was almost perfect for the individual items on the tool and moderate for the summary assessment. We have addressed a research gap by modifying and testing a tool to assess risk of study bias. Further research may be useful for assessing the applicability of the tool across different conditions. Copyright © 2012 Elsevier Inc. All rights reserved.
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            Juvenile idiopathic arthritis.

            Angelo Ravelli, Alberto Martini (2007)
            Juvenile idiopathic arthritis is a broad term that describes a clinically heterogeneous group of arthritides of unknown cause, which begin before 16 years of age. This term encompasses several disease categories, each of which has distinct methods of presentation, clinical signs, and symptoms, and, in some cases, genetic background. The cause of disease is still poorly understood but seems to be related to both genetic and environmental factors, which result in the heterogeneity of the illness. Although none of the available drugs has a curative potential, prognosis has greatly improved as a result of substantial progresses in disease management. The most important new development has been the introduction of drugs such as anticytokine agents, which constitute a valuable treatment option for patients who are resistant to conventional antirheumatic agents. Further insights into the disease pathogenesis and treatment will be provided by the continuous advances in understanding of the mechanisms connected to the immune response and inflammatory process, and by the development of new drugs that are able to inhibit selectively single molecules or pathways.
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              Prevalence and incidence of juvenile idiopathic arthritis: a systematic review.

              Sigrid Thierry, Bruno Fautrel, Irène Lemelle … (2014)
              To conduct a systematic literature review on incidence and prevalence of juvenile idiopathic arthritis and to estimate these figures in Europe for 2010. Articles on incidence or prevalence of juvenile idiopathic arthritis were searched in Medline. Pooled incidence and prevalence were calculated overall, by gender, age, classification and arthritis categories. We used the available age and gender pooled rates to standardize the incidence and prevalence on the 2010 European population and estimate the number of cases in Europe in 2010. Forty-three articles (33 on incidence, 29 on prevalence) were included. Incidence rates varied from 1.6 to 23 and prevalence from 3.8 to 400/100,000. Pooled incidence and prevalence were higher for girls (10.0 [9.4-10.7] and 19.4 [18.3-20.6]/100,000) than boys (5.7 [5.3-6.2] and 11.0 [10.2-11.9]/100,000). Oligoarthritis was the most frequent form (pooled incidence rate 3.7 [3.5-3.9] and prevalence 16.8 [15.9-17.7]/100,000). The direct standardized incidence rate was 8.2 [7.5-9.0] and prevalence 70.2 [62.9-78.1]/100,000. In Europe in 2010, the estimated number of incident cases was 6896 [5481-8578] and 59,175 [44,256-76,983] prevalent cases. Incidence and prevalence varied greatly among published reports of juvenile idiopathic arthritis, which may be explained by methodological issues, classification used, and time. Estimating the number of affected children can be useful, especially with the new treatment possibilities. Copyright © 2013 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.
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                Author and article information

                Contributors
                Sulaiman M. Al-Mayouf:
                ORCID: http://orcid.org/0000-0003-0142-6698
                mayouf@kfshrc.edu.sa
                Journal
                Journal ID (nlm-ta): Pediatr Rheumatol Online J
                Journal ID (iso-abbrev): Pediatr Rheumatol Online J
                Title: Pediatric Rheumatology Online Journal
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1546-0096
                Publication date (Electronic): 2 December 2021
                Publication date PMC-release: 2 December 2021
                Publication date Collection: 2021
                Volume: 19
                Electronic Location Identifier: 166
                Affiliations
                [1 ]GRID grid.411335.1, ISNI 0000 0004 1758 7207, Pediatric Rheumatology, King Faisal Specialist Hospital and Research Center College of Medicine, , Alfaisal University, ; Po Box 3354, Riyadh, 11211 Saudi Arabia
                [2 ]GRID grid.413288.4, ISNI 0000 0004 0429 4288, Al Adan Hospital, ; Hadiya, State of Kuwait
                [3 ]Department of Rheumatology and Pediatric Internal Medicine, University Hospital IBN Rochd, Casablanca, Morocco
                [4 ]Pfizer Biopharmaceutical Group, Emerging Markets, Dubai, United Arab Emirates
                [5 ]Department of Pediatrics, University Hospital Center of Batna Faculty of Medicine, Batna 2 University, Batna, Algeria
                [6 ]GRID grid.7776.1, ISNI 0000 0004 0639 9286, Professor of Pediatrics and Pediatric Rheumatology, , Cairo University, ; Giza, Egypt
                [7 ]GRID grid.7836.a, ISNI 0000 0004 1937 1151, Division of Paediatric Rheumatology, Department of Paediatrics and Child Health, , University of Cape Town, ; Cape Town, South Africa
                [8 ]Consultant Rheumatologist, Al Jalila Children’s Specialty Hospital, Dubai, United Arab Emirates
                [9 ]Pfizer Biopharmaceutical Group, Emerging Markets, Cairo, Egypt
                Author information
                http://orcid.org/0000-0003-0142-6698
                Article
                Publisher ID: 650
                DOI: 10.1186/s12969-021-00650-x
                PMC ID: 8638433
                PubMed ID: 34857004
                SO-VID: 1ae7365a-9536-4b19-9acd-405757838820
                Copyright © © The Author(s) 2021
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 14 July 2021
                Date accepted : 15 November 2021
                Funding
                Funded by: Pfizer Ltd
                Categories
                Subject: Review
                Custom metadata
                issue-copyright-statement © The Author(s) 2021

                ScienceOpen disciplines: Pediatrics
                Data availability:
                ScienceOpen disciplines: Pediatrics

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