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Prevalence of musculoskeletal complaints and juvenile idiopathic arthritis in children from a developing country: a
Bonnie Abujam1, Rishabh Mishra, Amita Aggarwal
1Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Insights
Musculoskeletal complaints are common in Indian children, with juvenile idiopathic arthritis (JIA) affecting an estimated 48 per 100,000. This study highlights the need for awareness of these conditions in developing countries.
Area of Science:
- Pediatrics
- Rheumatology
- Public Health
Background:
- Musculoskeletal complaints are frequent in children globally.
- Data on juvenile idiopathic arthritis (JIA) prevalence in developing nations, like India, is limited.
- Existing studies from developed countries suggest JIA affects less than 0.1% of children.
Purpose of the Study:
- To determine the prevalence of musculoskeletal complaints in Indian school children.
- To estimate the prevalence of juvenile idiopathic arthritis (JIA) in this population.
- To provide data from a developing country context.
Main Methods:
- A cross-sectional study involving 2059 school children aged 6-17 years in northern India.
- Questionnaires on musculoskeletal complaints were administered to children and/or parents.
- A standardized musculoskeletal examination (GALS) was performed, with further investigations for suspected inflammatory arthritis.
Main Results:
- The prevalence of joint pain (lasting >1 week) was 7.6%, back pain 3.1%, and heel pain 3%.
- Limb pains suggestive of 'growing pains' were reported by 2.1% of children.
- One case of JIA (enthesitis-related arthritis) was confirmed, yielding an estimated prevalence of 48/100,000.
Conclusions:
- Musculoskeletal complaints are prevalent among children in India.
- The estimated prevalence of juvenile idiopathic arthritis (JIA) in Indian children is 48 per 100,000.
- Further research is needed to understand the full spectrum of pediatric rheumatic diseases in developing countries.
Introduction:
Musculoskeletal complaints are common in children. Studies from developed countries have found most to be non-inflammatory and juvenile idiopathic arthritis (JIA) to be less than 0.1%. However, there is limited data from developing countries such as India.
Methods:
This cross-sectional study was conducted from March 2010 to April 2011 among school children aged 6-17 years in northern India. Prevalence of musculoskeletal complaints and JIA were determined using a questionnaire on musculoskeletal complaints. This was filled either by parents (always in children < 14 years) or children themselves. Subsequently, all children were individually met and responses verified. An abbreviated musculoskeletal examination (GALS) was performed on every child. In cases of suspected inflammatory arthritis, further investigations were performed.
Results:
Of the 2059 children (851 girls, 1208 boys) who were included in this study, mean (± SD) age was 11.5 ± 2.9 years. Joint pain (more than 1 week) was present in 158 (7.6%), back pain in 63 (3.1%) and heel pain in 62 (3%) of them. Limb pains, suggestive of 'growing pains', were present in 45 (2.1%) children. There were six suspected cases of inflammatory musculoskeletal pain; however, only one child was confirmed as having JIA (enthesitis-related arthritis). The estimated prevalence of JIA was 48/100,000 in Indian children.
Conclusion:
Musculoskeletal complaints were not uncommon in children from a developing country like India. Estimated prevalence of JIA was 48/100,000 (95%CI 10-280).
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