E09 Juvenile idiopathic athritis: a desk review of the available standard treatment guidelines in East Africa

Abstract

Abstract Background Juvenile Idiopathic Arthritis (JIA) is a common rheumatic disorder in children, with an estimated prevalence of 1 out of every 1000 children worldwide. In Tanzania, a retrospective review of pediatric patients with pediatric rheumatology conditions for seven years, reported JIA as the most prevalent condition. Timely initiation of therapy and availability of appropriate pharmacotherapy halts morbidity and mortality. Treatment guidelines for this condition is a key in guiding appropriate management. Aim This review was conducted to determine the availability of treatment guidelines for JIA in East Africa and compare them with the international guidelines. Methodology This was a desk review of available treatment guidelines for juvenile idiopathic arthritis in East Africa and as well international guidelines for comparison. The search was done on google, google scholar, Medline, HINARI and PubMed. The international guidelines were obtained from the respective webpages of the academic associations for rheumatology disorders. The search words entered in the data bases included ‘JIA treatment guidelines’, ‘Systemic arthritis treatment guidelines’, and ‘treatment guidelines for pediatric arthritis’. Each of the words was entered in the search engine with the names of the East African countries separately. Results There are no available standard guidelines for treatment of juvenile idiopathic arthritis in East Africa. However, available experts contextualize the international guidelines to attend local patients. This happens amidst a region with scarce resources. In a few available studies including ones conducted by A. Migowa et al. and M. Kamau et al. treatment includes use of NSAIDS for pain management, and corticosteroids for treatment bridging until Disease Modifying Anti-Rheumatic Drugs (DMARDS) become effective. Availability of biologics is not consistent in all the hospitals and their access is limited in third world countries (M. Kamau et al.). The reliable Disease Modifying Anti-Rheumatic Drugs of choice remain to be the convectional ones. The international guidelines exist for other regions including Europe (EULAR), America (ACR), and Asia pacific regions (APLAR). Conclusion There is a need to develop standard treatment guidelines in our settings in order to guide clinicians to best manage patients with JIA with the available treatment options in our setting.