Department of Paediatrics and Child Health, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Department of Paediatrics and Child Health, Muhimbili National Hospital, Dar es Salaam, Tanzania.
Pediatr Rheumatol Online J. 2020 Apr 3;18(1):30. doi: 10.1186/s12969-020-0418-2.
Paediatric rheumatic disorders are common in children and result in significant impairment in quality of life, morbidity and mortality. There is limited information on the burden of these disorders in lower income countries especially in sub-Saharan Africa. Few case reports have documented presence of paediatric rheumatic disorders in Tanzania. This study was conducted to determine the spectrum of rheumatic disorders among children at Muhimbili National Hospital (MNH).
This was a retrospective study conducted among children who were attended at MNH between January 2012 and August 2019. Paediatric patients seen in the out-patient clinics and those admitted in the wards were eligible. All patients with diagnosis of rheumatic disorders were identified from admission books and outpatient clinic logbooks, and later data were collected from their case notes and were recorded in clinical research forms. Collected information included age, sex, clinical features and laboratory tests results.
A total of 52 children with mean age of 9.5 ± 4.3 years, 12 (40.4%) participants were aged above 10 years and 32 (61.5%) were females. Frequently reported clinical presentations were joint pain 44 (84.6%), joint swelling 34 (65.4%), fever 24 (46.2%) and skin rashes 21(40.4%). Juvenile idiopathic arthritis (JIA) was the predominant diagnosis reported in 28 (53.8%) participants followed by juvenile systemic lupus erythematosus 8 (15.4%), mixed connective tissue diseases 4 (7.7%) and juvenile dermatomyositis 4 (7.7%). Antinuclear antibody test was performed in 16 participants it was positive in 9 (56.2%). Nine participants were tested for anti-double stranded DNA test and 5 (55.6%) were positive for this test. C-reactive protein was tested in 46 participants out of which 32 (69.6%) had elevated levels. HIV was tested in 24 (46.2%) participants and results were negative. Thirty-five out of 52 (67.3%) participants had anaemia. Predominant drugs used for treatment of JIA include prednisolone and methotrexate.
Paediatric rheumatic disorders are not uncommon in Tanzania-and were noted to affect more female children in this study. Predominant conditions included juvenile idiopathic arthritis (JIA), juvenile systemic lupus erythematosus (JSLE) and juvenile dermatomyositis (JDM).
儿科风湿性疾病在儿童中很常见，会导致生活质量显著受损、发病率和死亡率升高。关于这些疾病在低收入国家的负担情况，尤其是撒哈拉以南非洲地区，信息有限。少数病例报告记录了坦桑尼亚儿科风湿性疾病的存在。本研究旨在确定穆希比利国家医院（MNH）儿科患者的风湿性疾病谱。
这是一项回顾性研究，纳入 2012 年 1 月至 2019 年 8 月期间在 MNH 就诊的儿童。门诊和病房住院的儿科患者均符合条件。从入院登记册和门诊日志中确定诊断为风湿性疾病的所有患者，然后从病历中收集数据并记录在临床研究表格中。收集的信息包括年龄、性别、临床特征和实验室检查结果。
共纳入 52 名儿童，平均年龄为 9.5±4.3 岁，12 名（40.4%）参与者年龄大于 10 岁，32 名（61.5%）为女性。常见的临床表现为关节痛 44 例（84.6%）、关节肿胀 34 例（65.4%）、发热 24 例（46.2%）和皮疹 21 例（40.4%）。青少年特发性关节炎（JIA）是报告最多的诊断，共 28 例（53.8%），其次是青少年系统性红斑狼疮 8 例（15.4%）、混合性结缔组织病 4 例（7.7%）和青少年皮肌炎 4 例（7.7%）。16 名参与者进行了抗核抗体检测，其中 9 名（56.2%）阳性。9 名参与者进行了抗双链 DNA 检测，其中 5 名（55.6%）阳性。46 名参与者进行了 C 反应蛋白检测，其中 32 名（69.6%）升高。24 名参与者进行了 HIV 检测，结果均为阴性。52 名参与者中有 35 名（67.3%）贫血。治疗 JIA 的主要药物包括泼尼松龙和甲氨蝶呤。
儿科风湿性疾病在坦桑尼亚并不少见，本研究发现女性儿童发病率更高。主要疾病包括青少年特发性关节炎（JIA）、青少年系统性红斑狼疮（JSLE）和青少年皮肌炎（JDM）。
