Hamdi Wafa, Migowa Angela, Ferjani Hanene Lassoued, Makhloufi Chafia Dahou, Makhlouf Yasmine, Nasef Samah Ismail, Ziade Nelly, Baraliakos Xenophone, Brunner Hermine, Hassan Mohammed, Libe Temesgen, Palalane Elisa, Hassan Waleed, Sobh Ali, Seri Ahmed, Mosad Doaa, Lishan Hanna, Taha Yassmin, Gacem Ourida, Hashed Soad, Furia Francis Fredrick, Slimani Samy, Scott Christiaan, Hadef Djohra
Department of Rheumatology, Faculty of Medicine of Tunis, Kassab Institute, Tunis El Manar University, UR17SP04, Tunis, Tunisia.
Department of Pediatrics, Aga Khan University Medical College East Africa, Nairobi, P.O. Box 30270, Nairobi, 00100, Kenya.
Clin Rheumatol. 2025 Mar;44(3):901-922. doi: 10.1007/s10067-025-07334-x. Epub 2025 Feb 1.
The objective of this study is to develop evidence-based recommendations for the diagnosis and management of enthesitis-related arthritis (ERA) and juvenile psoriatic arthritis (JPsA) in the African context. The recommendations for ERA and JPsA were combined into a single document. The steering committee and task force identified 15 key questions and formulated 35 research questions. A comprehensive literature review, utilizing Medline and a manual search for African local data, was conducted to gather evidence. Following this synthesis, the task force developed draft recommendations and engaged in a Delphi process with an expert panel, including 17 African and three international experts, to reach a consensus and ensure alignment with global standards. The final recommendations were assigned a level of evidence and subsequently approved by the task force members, the expert panel, and the PAFLAR Board. Fifteen recommendations on the diagnosis and management of ERA and JPsA were developed, covering the role of the pediatric rheumatologist in multiple aspects of disease management, including diagnosis, monitoring of disease and extra-articular manifestations, determining treatment strategies, and guiding interventions. The level of evidence supporting these recommendations was variable, leading to the identification of a research agenda to address African particularities and answer pending questions. The final recommendations achieved a high level of agreement, with consensus ranging from 90 to 100%. These recommendations represent an important achievement for pediatric rheumatology in Africa, being the first of their kind, tailored specifically to the region. Developed through a rigorous methodology and collaboration between international and African experts, they aim to standardize care and address the unique challenges faced in African setting.
本研究的目的是在非洲背景下，为附着点炎相关关节炎（ERA）和青少年银屑病关节炎（JPsA）的诊断和管理制定基于证据的建议。ERA和JPsA的建议被整合到一份文件中。指导委员会和特别工作组确定了15个关键问题，并制定了35个研究问题。通过使用Medline进行全面的文献综述，并手动搜索非洲本地数据，以收集证据。在此综合之后，特别工作组制定了建议草案，并与一个专家小组进行了德尔菲法程序，该专家小组包括17名非洲专家和3名国际专家，以达成共识并确保与全球标准一致。最终建议被赋予了证据级别，随后由特别工作组成员、专家小组和PAFLAR委员会批准。制定了15条关于ERA和JPsA诊断和管理的建议，涵盖了儿科风湿病学家在疾病管理多个方面的作用，包括诊断、疾病和关节外表现的监测、确定治疗策略以及指导干预措施。支持这些建议的证据级别各不相同，因此确定了一个研究议程，以解决非洲的特殊性并回答悬而未决的问题。最终建议达成了高度一致，共识范围从90%到100%。这些建议是非洲儿科风湿病学的一项重要成就，是同类建议中的首个，专门针对该地区量身定制。通过严格的方法以及国际和非洲专家之间的合作制定而成，旨在规范护理并应对非洲环境中面临的独特挑战。
