Paediatric rheumatology clinic population in Southeast Asia: are we different?

Arkachaisri T 1 , Tang SP 2 , Daengsuwan T 3 , Phongsamart G 3 , Vilaiyuk S 4 , Charuvanij S 5 Show all authors , Hoh SF 6 , Tan JH 1 , Das L 1 , Ang E 7 , Lim W 7 , Chan YH 8 , Bernal CB 9 , Asia Pacific Pediatric Rheumatology Education and Research Network

Affiliations 

  • 1 Rheumatology and Immunology Service, Department of Pediatric Subspecialties, KK Women's and Children's Hospital
  • 2 Pediatric Rheumatology Unit, Selayang Hospital, Kuala Lumpur, Malaysia
  • 3 Department of Pediatrics, Queen Sirikit National Institute of Child Health
  • 4 Division of Pediatric Rheumatology, Department of Pediatrics, Ramathibodi Hospital
  • 5 Division of Pediatric Rheumatology, Department of Pediatrics, Siriraj Hospital, Bangkok, Thailand
  • 6 Division of Nursing, KK Women's and Children's Hospital
  • 7 Division of Pediatric Allergy, Immunology and Rheumatology, Department of Pediatrics
  • 8 Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  • 9 Pediatric Rheumatology Section, Department of Pediatrics, University of Santo Tomas Hospital, Manila, Philippines
Rheumatology (Oxford), 2017 03 01;56(3):390-398.
PMID: 27994096 DOI: 10.1093/rheumatology/kew446

Abstract

Objectives: To examine the descriptive epidemiology of the patient population referred to paediatric rheumatology centres (PRCs) in Southeast Asia (SEA) and to compare the frequency of conditions encountered with other PRC populations.

Methods: A web-based Registry for Childhood Onset Paediatric Rheumatic Diseases was established in 2009 and seven PRCs in four SEA countries, where paediatric rheumatologists are available, participated in a prospective 24 month data collection (43 months for Singapore).

Results: The number of patients analysed was 4038 (788 from Malaysia, 711 from the Philippines, 1943 from Singapore and 596 from Thailand). Over 70% of patients evaluated in PRCs in Malaysia, the Philippines and Thailand had rheumatic diseases (RDs), as compared with one-half of the proportion seen in Singaporean PRCs, which was similar to the Western PRC experience. Among RDs diagnosed (n = 2602), JIA was the most common disease encountered in Malaysia (41%) and Thailand (61%) as compared with systemic vasculitides in the Philippines (37%) and Singapore (35%) among which Henoch-Schönlein purpura was the most prevalent. SLE and related diseases were more common, but idiopathic pain syndrome and abnormal immunological laboratory tests were rarer than those seen in the West. JIA subtype distributions were different among countries. Among non-RDs (n = 1436), orthopaedic and related conditions predominated (21.7-59.4%).

Conclusion: The frequencies of RDs seen by SEA PRCs were different from those in the West. Systemic vasculitides and SLE were common in addition to JIA. Paediatric rheumatologist availability and healthcare accessibility partially explain these observed discrepancies.

Study site: multination + Selayang Hospital, Malaysia

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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