National Institute of Arthritis, Musculoskeletal and Skin Diseases, NIH, DHHS, Bethesda, Maryland, USA.
Curr Opin Rheumatol. 2020 Sep;32(5):414-420. doi: 10.1097/BOR.0000000000000726.
To highlight the current challenges in diagnosis and clinical care of pediatric rheumatic disease and barriers to research and education of pediatric rheumatologists worldwide.
Recent studies and reports demonstrate a paucity of studies on epidemiology, outcomes, and management guidelines from many regions of the world. There have been noteworthy efforts to bridge the gap in under resourced areas. An analysis of the global burden of rheumatic disease has demonstrated that while understudied, musculoskeletal diseases are prevalent and increasingly contribute to loss of years of healthy life. In juvenile idiopathic arthritis, two milestone publications in global pediatric rheumatology have recently been published. An international study evaluated the epidemiology, treatment, and outcomes of juvenile idiopathic arthritis and demonstrated global diversity in both clinical manifestations and outcomes. Notably, the first guidelines for managing pediatric rheumatic disease in a less resourced setting have been published for juvenile idiopathic arthritis. This document offers the first publication targeted to address challenges faced by pediatric rheumatology caregivers in low-resourced settings. These documents serve as exemplars for international collaboration in pediatric rheumatology and can be used as models for other pediatric rheumatic disease research. Other efforts are making progress in various arenas towards increasing access to care, education, and training in pediatric rheumatology.
The global burden of rheumatic disease in the pediatric population is poorly understood but unrecognized disease greatly impacts the overall morbidity and mortality in this population. More studies in lesser resourced regions are needed to prioritize access to pediatric rheumatology care and prioritize a further increase in research capacity and education moving forward.
强调儿科风湿性疾病诊断和临床护理方面的当前挑战,以及全球儿科风湿病医生研究和教育方面的障碍。
最近的研究和报告表明,世界许多地区在流行病学、结局和管理指南方面的研究很少。在资源匮乏地区,人们做出了许多值得关注的努力来弥补这一差距。对风湿性疾病全球负担的分析表明,尽管研究不足,但肌肉骨骼疾病普遍存在,并越来越多地导致健康生命年数的损失。在幼年特发性关节炎中,全球儿科风湿病学最近发表了两项具有里程碑意义的研究。一项国际研究评估了幼年特发性关节炎的流行病学、治疗和结局,并表明在临床表现和结局方面存在全球多样性。值得注意的是,已经为资源较少的环境中管理小儿风湿性疾病制定了第一套指南。该文件首次针对资源较少环境中儿科风湿病护理人员面临的挑战提供了出版物。这些文件是儿科风湿病学国际合作的范例,可以作为其他儿科风湿性疾病研究的模型。其他努力也在各个领域取得进展,以增加小儿风湿病学的护理、教育和培训机会。
儿科人群中风湿性疾病的全球负担了解甚少,但未被识别的疾病严重影响了该人群的整体发病率和死亡率。需要在资源较少的地区开展更多研究,优先考虑获得小儿风湿病学护理的机会,并进一步提高研究能力和教育水平。