Paediatric rheumatology--a global perspective.
This chapter aims to give a global perspective to paediatric rheumatology. The main points covered are the incidence, recognition of paediatric autoimmune diseases, and ethnic/geographic distribution. The most prevalent disease is juvenile idiopathic arthritis; robust data are still required for childhood-onset systemic lupus erythematosus, dermatomyositis, and scleroderma. Mimicking or overlapping infections are a major challenge in developing countries, and immunization policies in our patients in these areas need specific attention. The delivery of paediatric rheumatology care is also overviewed. Discrepancies in health-care resources and priorities are found in developing countries. Although most anti-rheumatic treatments are available worldwide, they are prohibitively expensive in many countries. For more traditional anti-rheumatic drugs there is still an ongoing need for good core outcome data across the world to ensure valid comparisons. Parent/patient education has been implemented worldwide in paediatric rheumatology through the power of the Internet. Physician and undergraduate training goals must be met to facilitate competent musculoskeletal assessment, a proper understanding of age-dependent variations, diagnosis, referral to specialists, and improved standards of care.
Sawhney
Sujata
S
Department of Paediatric Rheumatology, Centre for Child Health, Sir Ganga Ram Hospital, New Delhi 110060, India. sujatasawney@vsnl.net
Magalhães
Claudia Saad
CS
D000367:Age Factors; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004503:Education, Medical, Graduate; D005260:Female; D005500:Follow-Up Studies; D014943:Global Health; D006801:Humans; D008297:Male; D010808:Physical Examination / Q000379:methods; D026741:Physical Therapy Modalities; D017410:Practice Guidelines as Topic; D016059:Range of Motion, Articular / Q000502:physiology; D012219:Rheumatology / Q000193:education / Q000592:standards*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
D018501:Antirheumatic Agents