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Paediatric rheumatology--a global perspective
Sujata Sawhney1, Claudia Saad Magalhães
1Department of Paediatric Rheumatology, Centre for Child Health, Sir Ganga Ram Hospital, New Delhi 110060, India. sujatasawney@vsnl.net
Insights
Paediatric rheumatology offers a global view of autoimmune diseases in children, highlighting juvenile idiopathic arthritis as most common. Challenges include infections in developing nations and unequal access to care and treatments.
Area of Science:
- Pediatric Rheumatology
- Autoimmune Diseases
- Global Health
Background:
- Paediatric rheumatology provides a global overview of childhood autoimmune diseases.
- Key aspects include incidence, recognition, and geographic distribution.
- Juvenile idiopathic arthritis is the most prevalent condition.
Purpose of the Study:
- To present a global perspective on paediatric rheumatology.
- To identify challenges in disease recognition and care delivery.
- To highlight disparities in healthcare resources and treatment accessibility.
Main Methods:
- Review of global data on paediatric autoimmune diseases.
- Analysis of challenges in developing countries, including infections and immunization.
- Overview of paediatric rheumatology care delivery and treatment availability.
Main Results:
- Juvenile idiopathic arthritis is the most common disease; data for other conditions like lupus and scleroderma are insufficient.
- Infections pose significant challenges in developing countries, requiring attention to immunization policies.
- Significant disparities exist in healthcare resources and treatment costs globally.
Conclusions:
- Improved core outcome data are needed for traditional anti-rheumatic drugs.
- Parent and patient education is enhanced by the internet.
- Enhanced physician and undergraduate training is crucial for better musculoskeletal assessment, diagnosis, and care standards.
Abstract:
This chapter aims to give a global perspective to paediatric rheumatology. The main points covered are the incidence, recognition of paediatric autoimmune diseases, and ethnic/geographic distribution. The most prevalent disease is juvenile idiopathic arthritis; robust data are still required for childhood-onset systemic lupus erythematosus, dermatomyositis, and scleroderma. Mimicking or overlapping infections are a major challenge in developing countries, and immunization policies in our patients in these areas need specific attention. The delivery of paediatric rheumatology care is also overviewed. Discrepancies in health-care resources and priorities are found in developing countries. Although most anti-rheumatic treatments are available worldwide, they are prohibitively expensive in many countries. For more traditional anti-rheumatic drugs there is still an ongoing need for good core outcome data across the world to ensure valid comparisons. Parent/patient education has been implemented worldwide in paediatric rheumatology through the power of the Internet. Physician and undergraduate training goals must be met to facilitate competent musculoskeletal assessment, a proper understanding of age-dependent variations, diagnosis, referral to specialists, and improved standards of care.
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