E-ISSN 1858-8360 | ISSN 0256-4408
 

Review Article 


Challenges in the diagnosis and management of Pediatric Rheumatology in the developing world: Lessons from a newly established clinic in Yemen

Haifa Ali Bin Dahman.

Abstract
Pediatric rheumatology is still considered a mysterious branch of pediatric medicine, especially among developing countries. Long-term consequences usually follow delayed diagnosis, referral, and management of rheumatic disorders. We aim to describe the clinical spectrum and the frequency of pediatric rheumatic diseases (PRDs) in AL-Mukalla hospital in Hadhramout province/Yemen. A case record retrospective study was conducted among all patients who attended the pediatric rheumatology clinic in Al-Mukalla hospital (from January 2010 to December 2016) with a musculoskeletal complaint or systemic symptoms suggestive of rheumatic disease.
Data collected included: gender, address, age at the onset of symptoms, initial manifestations, the presence of complications, referral diagnosis, final diagnosis and the lag period before attending the rheumatology clinic. PRDs were present in 86% (37/43) of cases, 83.8% (31/37) were from Hadhramout province. Male to female ratio was 0.9:1 (Male: 18; Female: 19) and the commonest age group affected was (>9-12) years. The mean age at first presentation was 8.859 4.11 years (four months-14 years). One year (0.13-98.4 months) was the median time before referral to the rheumatologist. About 70.3% of cases were referred from other specialists or peripheral hospitals. Joint swelling (54.1%) was the most common presentation and juvenile idiopathic arthritis (24.3%) was the commonest diagnosis. The discrepancy between the referral and the final diagnosis was noticed in 21(48.8%) cases. Only eight
cases (18.6%) matched the final diagnosis. Two patients died with a mortality rate of 5.4%. Knowledge of the spectrum and incidence of PRDs will increase the awareness of specialists and general practitioners for early referral and diagnosis to avoid long-term sequels.

Key words: Arthritis, Mukalla, Pediatric rheumatic diseases, Rheumatology, Yemen


 
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Pubmed Style

Haifa Ali Bin Dahman. Challenges in the diagnosis and management of Pediatric Rheumatology in the developing world: Lessons from a newly established clinic in Yemen. Sudan J Paed. 2017; 17(2): 21-29. doi:10.24911/SJP.2017.2.2


Web Style

Haifa Ali Bin Dahman. Challenges in the diagnosis and management of Pediatric Rheumatology in the developing world: Lessons from a newly established clinic in Yemen. http://www.sudanjp.com/?mno=284181 [Access: April 03, 2020]. doi:10.24911/SJP.2017.2.2


AMA (American Medical Association) Style

Haifa Ali Bin Dahman. Challenges in the diagnosis and management of Pediatric Rheumatology in the developing world: Lessons from a newly established clinic in Yemen. Sudan J Paed. 2017; 17(2): 21-29. doi:10.24911/SJP.2017.2.2



Vancouver/ICMJE Style

Haifa Ali Bin Dahman. Challenges in the diagnosis and management of Pediatric Rheumatology in the developing world: Lessons from a newly established clinic in Yemen. Sudan J Paed. (2017), [cited April 03, 2020]; 17(2): 21-29. doi:10.24911/SJP.2017.2.2



Harvard Style

Haifa Ali Bin Dahman (2017) Challenges in the diagnosis and management of Pediatric Rheumatology in the developing world: Lessons from a newly established clinic in Yemen. Sudan J Paed, 17 (2), 21-29. doi:10.24911/SJP.2017.2.2



Turabian Style

Haifa Ali Bin Dahman. 2017. Challenges in the diagnosis and management of Pediatric Rheumatology in the developing world: Lessons from a newly established clinic in Yemen. Sudanese Journal of Paediatrics, 17 (2), 21-29. doi:10.24911/SJP.2017.2.2



Chicago Style

Haifa Ali Bin Dahman. "Challenges in the diagnosis and management of Pediatric Rheumatology in the developing world: Lessons from a newly established clinic in Yemen." Sudanese Journal of Paediatrics 17 (2017), 21-29. doi:10.24911/SJP.2017.2.2



MLA (The Modern Language Association) Style

Haifa Ali Bin Dahman. "Challenges in the diagnosis and management of Pediatric Rheumatology in the developing world: Lessons from a newly established clinic in Yemen." Sudanese Journal of Paediatrics 17.2 (2017), 21-29. Print. doi:10.24911/SJP.2017.2.2



APA (American Psychological Association) Style

Haifa Ali Bin Dahman (2017) Challenges in the diagnosis and management of Pediatric Rheumatology in the developing world: Lessons from a newly established clinic in Yemen. Sudanese Journal of Paediatrics, 17 (2), 21-29. doi:10.24911/SJP.2017.2.2





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