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McColl J, Mwizerwa O, Scott C, Tse SM, Foster HE. Pediatric rheumatology education: the virtual frontier a review. Pediatr Rheumatol Online J 2024; 22:60. [PMID: 38840147 PMCID: PMC11155138 DOI: 10.1186/s12969-024-00978-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/24/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Many children with rheumatic and musculoskeletal diseases are unrecognized. Identifying these children requires health care provider awareness, knowledge, and skills to recognize disease features and how (and when) to refer to specialist care. The aim of this paper is to highlight the need for better access to health care, review the essential role that education and virtual care play to address unmet need in low resource areas and especially to expand workforce capacity. Using collaborative partnerships, virtual platforms, and innovative assessment methods, musculoskeletal care and education can be delivered to reach a greater audience than ever before. Increased awareness through multiple initiatives and readily available resources are imperative to improve global rheumatology care. CONCLUSION The needs of children with rheumatic diseases and musculoskeletal conditions are vastly underserved around the world resulting in preventable morbidity and mortality. Expanded implementation of virtual education and e-health care platforms provides an opportunity to increase access to care for children globally.
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Affiliation(s)
- Jeanine McColl
- Department of Pediatrics, Division of Rheumatology, University of Calgary, Calgary, AB, Canada.
- Department of Pediatrics, Division of Rheumatology, University of Calgary, Alberta Children's Hospital, 28 Oki Drive NW, T3B 6A8, Calgary, AB, Canada.
| | - Oscar Mwizerwa
- Department of Pediatrics, Division of Rheumatology, University of Toronto, The Hospital for Sick Children, 170 Elizabeth St, M5G 1E8, Toronto, ON, Canada
| | - Christiaan Scott
- Clinical Research Centre, University of Cape Town. Red Cross War Memorial Children's Hospital, Anzio Road Observatory, 7700, Cape Town, Western Cape, South Africa
| | - Shirley Ml Tse
- Department of Pediatrics, Division of Rheumatology, University of Toronto, The Hospital for Sick Children, 170 Elizabeth St, M5G 1E8, Toronto, ON, Canada
| | - Helen E Foster
- Population and Health Institute, Newcastle University, Framlington Place, NE1 7RU, Newcastle upon Tyne, Tyne and Wear, UK
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Editorial-Rheumatology in Africa. Clin Rheumatol 2021; 40:3391. [PMID: 34318361 PMCID: PMC8315894 DOI: 10.1007/s10067-021-05865-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 07/15/2021] [Accepted: 07/15/2021] [Indexed: 11/18/2022]
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Migowa AN, Hadef D, Hamdi W, Mwizerwa O, Ngandeu M, Taha Y, Ayodele F, Webb K, Scott C. Pediatric rheumatology in Africa: thriving amidst challenges. Pediatr Rheumatol Online J 2021; 19:69. [PMID: 33962643 PMCID: PMC8103667 DOI: 10.1186/s12969-021-00557-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 04/16/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Pediatric Rheumatology is an orphan specialty in Africa which is gradually gaining importance across the continent. MAIN BODY This commentary discusses the current state of affairs in the sphere of Pediatric Rheumatology across Africa and offers practical strategies to navigate the challenges encountered in research, models of care, education and training. We outline the establishment, opportunities of growth and achievements of the Pediatric Society of the African League Against Rheumatism (PAFLAR). CONCLUSION This commentary lays the foundation for establishment of a formidable framework and development of partnerships for the prosperity of Pediatric Rheumatology in Africa and beyond.
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Affiliation(s)
- Angela N. Migowa
- grid.470490.eAga Khan University Medical College East Africa, Department of Paediatrics and Child Health, 3rd Parklands Avenue, P. O Box 30270, Nairobi, Kenya
| | - Djohra Hadef
- Batna 2 University, Faculty of Medicine, 05000 Ezzohor city, Batna Algeria
| | - Wafa Hamdi
- grid.12574.350000000122959819University of Tunis El Manar, Campus Universitaire Farhat Hached B.P. n° 94 Rommana Tunis, 1068 Tunis, Tunisia
| | - Oscar Mwizerwa
- grid.10818.300000 0004 0620 2260University of Rwanda, KG 11 Ave, Kigali, Rwanda
| | - Madeleine Ngandeu
- grid.412661.60000 0001 2173 8504University of Yaoundé, Boîte Postale 337, Yaoundé, Centre Region Cameroon
| | - Yassmin Taha
- Ahmed Gasim Children’s Hospital Khartoum, Sudan Bahri Street, Downtown, Tuti Island, Bahri, Khartoum State Sudan
| | - Faleye Ayodele
- grid.411278.90000 0004 0481 2583Lagos State University Teaching Hospital, Nigeria 1- 5 Oba Akinjobi Way, Street, Ikeja, Lagos Nigeria
| | - Kate Webb
- grid.7836.a0000 0004 1937 1151University of Cape Town, South Africa Rondebosch, Cape Town, 7700 South Africa
| | - Christiaan Scott
- grid.7836.a0000 0004 1937 1151University of Cape Town, South Africa Rondebosch, Cape Town, 7700 South Africa
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Alordiah CO, Owamah HI, Ogbinaka EJA, Alordiah MO. NIGERIA'S LOW CONTRIBUTION TO RECOGNIZED WORLD RESEARCH LITERATURE: CAUSES AND REMEDIES. Account Res 2020; 28:471-491. [PMID: 33237808 DOI: 10.1080/08989621.2020.1855984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We present a first-time study on identifying the causes and remedies to Nigeria's low contribution to globally recognized research literature. A mixed research approach involving 300 academic staff from several areas of specialization in southern Nigeria was adopted, using structured questionnaire and semi-structured interview schedule. Data obtained were analyzed using descriptive statistics and thematic technique. Furthermore, 43.7%, 28.6%, and 27.7% of the respondents were from the university, polytechnic, and college of education system, respectively. While 78.4% of the respondents agreed that the high cost of open access publication in top journals influenced Nigeria's low contribution to research literature, over 75% reported that the low contribution was due to high cost of attending international conferences. Other factors identified were stringent conditions for paper acceptance (89.7%), scarcity of relevant information about Africa (85.4%), and paucity of high-impact journals in the libraries of Nigerian tertiary institutions (6.7%). Others were poor funding, non-usage of research findings by policymakers, lack of adequate facilities, and high penchant for publication in predatory journals, informed by promotion criteria not supportive of quality. Participants advocated for increased funding, reduced conference fees, and entrenchment of collaboration between reputable publishers abroad and African publishers.
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Affiliation(s)
- C O Alordiah
- College of Education Agbor, Delta State, Nigeria
| | - H I Owamah
- Department of Civil & Environmental Engineering, Delta State University, Abraka, OlehCampus, Nigeria
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The management of gout in Africa: challenges and opportunities. Clin Rheumatol 2020; 40:3393-3400. [PMID: 32944884 DOI: 10.1007/s10067-020-05401-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/01/2020] [Accepted: 09/12/2020] [Indexed: 10/23/2022]
Abstract
The rise in non-communicable diseases in Africa presents challenges for health systems that are burdened by infectious diseases. Gout is one of those diseases that has seen an increase in numbers worldwide, including Africa. Gout is commonly associated with comorbidities and mortality. It directly impacts the quality of life, increases health costs, decreases physical function, and significantly increases the time from work, much of which is potentially avoided if treatment is instituted early. Despite advances in understanding the pathophysiology and outcomes of gout, the quality of care delivered to patients in Africa is still suboptimal. Existing data on gout in Africa reveals a general low index of suspicion due to limited knowledge of the disease by healthcare workers resulting in late diagnosis, with severe polyarticular tophaceous gout being a common presenting feature. These late presentations are associated with avoidable disability and increase the direct and indirect costs of managing gout. The challenges are related to lack of government budgetary support for staff training, infrastructure for diagnosis, and availing medicines. The picture of gout in Africa largely mirrors the west concerning risk factors, comorbidities, and burden of disease, but with some unique presentations seen in HIV, sickle cell disease, and vertigo. We discuss the challenges of gout diagnosis and management in Africa and propose a roadmap to improve gout outcomes across Africa.
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Scuccimarri R, Broten L, Migowa A, Ngwiri T, Wachira J, Bernatsky S, Hitchon C, Colmegna I. Frequency and spectrum of outpatient musculoskeletal diagnoses at a pediatric hospital in Kenya. Clin Rheumatol 2019; 38:1195-1200. [PMID: 30604040 DOI: 10.1007/s10067-018-4376-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 11/09/2018] [Accepted: 11/21/2018] [Indexed: 12/31/2022]
Abstract
Chronic pediatric musculoskeletal (MSK) conditions are a major cause of morbidity. The burden of pediatric rheumatic diseases in East Africa is largely unknown. The purposes of this study were to estimate frequencies and assess the spectrum of MSK-related diagnoses using ICD-10 diagnostic codes among outpatients at a pediatric hospital in Kenya and to evaluate the accuracy of the assigned codes used for the 'arthropathies' category. All pediatric outpatient diagnoses classified under the ICD-10 codes for 'diseases of the MSK system and connective tissue' (M00-M99) recorded between January and December 2011 were extracted from the electronic medical record system at Gertrude's Children's Hospital (GCH). For each of the ten MSK disease categories, frequencies were calculated. The assigned ICD10 code for cases in the 'arthropathies' (M00-M25) category was assessed by two rheumatologists. MSK diagnoses (n = 1078) accounted for 0.5% of all GCH outpatient consults available for analysis. 'Soft tissue disorders' were the most frequent MSK diagnoses (n = 614, 57%), followed by 'arthropathies' (n = 332, 30.8%), 'dorsopathies' (n = 81, 7.5%), 'osteopathies and chondropathies' (n = 39, 3.6%), and 'other' disorders (n = 12, 1.1%). No patients were classified in the category of 'systemic connective tissue disorders'. In cases classified as 'arthropathies', there was poor agreement (Kappa 0.136) between the ICD10 code assigned by the treating physicians and that assigned by the rheumatologists. However, when the rheumatologists' classification was loosened, agreement was moderate (Kappa 0.533). This study provides estimates of the frequency of outpatient MSK diagnoses at a pediatric hospital in Kenya in 2011. MSK diagnoses were not rare. Despite limitations of administrative databases to estimate frequencies of specific diagnoses, they provide a snapshot of the overall burden and spectrum of MSK conditions.
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Affiliation(s)
- Rosie Scuccimarri
- Division of Pediatric Rheumatology, Department of Pediatrics, McGill University Health Centre, Montreal, Quebec, Canada
| | - Laurel Broten
- Division of Rheumatology, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Angela Migowa
- Department of Pediatrics and Child Health, Aga Khan University Hospital (East Africa), Nairobi, Kenya
| | - Thomas Ngwiri
- Department of Pediatrics, Gertrude's Children's Hospital, Nairobi, Kenya
| | - John Wachira
- Department of Pediatrics, Gertrude's Children's Hospital, Nairobi, Kenya
| | - Sasha Bernatsky
- Division of Rheumatology & Division of Clinical Epidemiology, Department of Medicine & Department of Epidemiology, Biostatistics and Occupational Health, McGill University, McGill University Health Centre, Montreal, Quebec, Canada
| | - Carol Hitchon
- Division of Rheumatology, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Inés Colmegna
- Division of Rheumatology, Department of Medicine, Royal Victoria Hospital - M11-32, 1001 Decarie Boulevard, Montreal, Quebec, H4A 3J1, Canada.
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