EC Paediatrics

Background and Purpose: Previous studies show a disparity in the prevalence of Juvenile idiopathic arthritis (JIA) subsets between different geographical areas or ethnic groups. There is paucity of data that describes JIA in Arabic and African populations. The purpose of this study is to describe the main epidemiological characteristics of JIA in Batna-Algeria-and to compare the findings with other JIA populations worldwide.

Methods: We conducted a multicenter retrospective descriptive study based on data collected on JIA patients diagnosed in Batna health centers (public and private sectors), over a seven-year period from January 2013 to December 2019. The studied variables are: gender, age at the initial symptoms, age at diagnosis, JIA subtype based on International League of Associations for Rheumatology (ILAR) criteria, symptoms at onset, disease duration at the latest follow up, uveitis presence, auto antibodies pattern and joint imaging results, JIA medications, JIA status at the time of enrollment and the latest follow-up.

Results: Sixty-nine cases of JIA were collected. The female to male ratio was 1.83. The median age at diagnosis was 9 years (range 1 - 16). Forty-six patients (72%) were diagnosed within the first year after disease onset. At the latest follow-up, the median disease duration onset was 1 year (range 1 - 8 years). There were 34 oligoarthritis (49.3%), 9 polyarthritis rheumatoid factor (RF) negative (13%), 8 polyarthritis (RF) positive (11.6%), 6 systemic arthritis (8.7%), 6 enthesitis-related arthritis (8.7%), 3 psoriatic arthritis (4.3%), and 3 undifferentiated arthritis (4.3%). Nine patients (18.7%) were anti-nuclear antibody (ANA) positive, and 21 patients (30.4%) had indeterminate ANA status. Sixty-three patients (91.3%) had benefited from a slit lamp examination, uveitis was found in 7.9% of cases. The used medications included non-steroidal anti-inflammatory drugs (NSAIDs) in 54 patients (79.4%), steroids in 37 (54.4%), intra articular steroid injections in 17 (24.6%), conventional disease-modifying anti-rheumatic drug (cDMARDs) in 51 (72.5%), and biologic agents in 11 patients (15.9%).

Conclusion: Oligoarthritis was the most common JIA subtype in our study with cases of uveitis at diagnosis. The RF positive polyarthritis frequency was higher than in literature. The use of cDMARDs was common whilst few patients received biologics.

Keywords: Juvenile Idiopathic Arthritis; Epidemiological Features; Challenges; Algeria

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