Browsing by Author "Esser, Monika"

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    Characteristics and outcome of children with juvenile dermatomyositis in Cape Town: a cross-sectional study
    (BioMed Central, 2016-11-11) Okong’o, Lawrence O; Esser, Monika; Wilmshurst, Jo; Scott, Christiaan
    Background: Juvenile dermatomyositis (JDM) is a rare idiopathic inflammatory childhood myopathy of uncertain aetiology. The demographic and clinical presentation of JDM may differ by race and geographic regions. Few studies have described the characteristics of JDM patients from Africa. Methods: We conducted a retrospective observational study to determine clinical characteristics and outcomes of patients satisfying the Bohan and Peter criteria for probable JDM seen between 2004 and 2013 in three hospitals in Cape Town, South Africa. Results: Twenty five cases were identified: 16 female and 9 male; thirteen (52 %) were of indigenous African, eleven (44 %) mixed and one (4 %) European ancestry. The median ages at disease onset and diagnosis were 6.75 (range 2.0–9.7) and 7.9 (range 3.4–9.75) years respectively. Eleven patients had calcinosis while the mortality was 2/ 25 (8 %). Only 40 % of the patients had clinically inactive disease by PRINTO criteria (modified) at last review. There was no statistically significant difference in racial distribution (p-value = 1), age at disease onset (p-value = 0.87) and disease duration prior to treatment initiation (p-value = 0.75) between patients who had clinically active and inactive disease. Conclusion: The demographic characteristics of children with JDM were similar to that from most other regions of the world with female predominance and similar age at onset. Majority of the patients remained with clinically active disease, which put them at risk of further disease complications. Long term follow up and use of appropriate treatment guidelines may be indicated in management of JDM patients for optimum treatment outcomes.
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    Involving traditional health practitioners in HIV/AIDS interventions: Lessons from the Western Cape Province.
    (2008) Wreford, Joanne; Esser, Monika; Hippler, Stefan
    Despite international recognition of the potential value of collaboration between traditional health practitioners and western medicine, examples of this approach in South Africa are rare. Contextualised within the aims and objectives of the HIV/AIDS and STIs National Strategic Plan 2007-2011(NSP), the paper looks at one initiative, based in the Western Cape Province. It presents evidence of the scheme’s success to date, its potential for assisting in the NSP’s goals, and the possibility of further developments, which might enhance HIV/AIDS prevention and care strategies. Finally, the paper explores some key problems, and makes recommendations for future initiatives based on the experience.
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    Juvenile idiopathic arthritis (JIA) in two tertiary centres in the Western Cape, South Africa
    (BioMed Central Ltd, 2011) Weakley, Kate; Esser, Monika; Pope, Chris; Scott, Christiaan
    Background: JIA is a disease that shows wide variations between differing populations. Due to recent international consensus on classification criteria, JIA has been widely described in many countries and population groups. There has been almost no data that describes JIA in an African, specifically Sub-Saharan African setting. Objective: To describe disease characteristics and functional disability in two tertiary centres in the Western Cape, South Africa
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    Juvenile idiopathic arthritis in two tertiary centres in the Western Cape, South Africa
    (BioMed Central Ltd, 2012) Weakley, Kate; Esser, Monika; Scott, Christiaan
    BACKGROUND:Juvenile idiopathic arthritis (JIA) is a disease that shows wide variations between differing populations. Since the recent international consensus on classification criteria, JIA has been widely described in many countries and population groups. There has been almost no data that describes JIA in an African, specifically Sub-Saharan African, setting. Therefore, the aim of this study is to describe disease characteristics, disease course, and functional disability in two tertiary centres in the Western Cape, South Africa and compare the findings to other JIA populations. METHODS: Eighty-six children were recruited during random clinic visits to rheumatology clinics at Tygerberg and Groote Schuur Hospital between April 2010 and April 2011. Children were diagnosed using International League of Associations for Rheumatology (ILAR) 2001 classification criteria. Consent was obtained and medical records examined. The Childhood Health Assessment Questionnaires (CHAQ) and visual analogue scales (VAS) for pain and general well-being were completed and all children were examined by a researcher in conjunction with a paediatric rheumatologist. HIV status as well as tuberculosis disease and treatment were investigated. RESULTS: A total of 86 children were enrolled. Eight children were excluded (2 HIV arthropathy, 1 TB arthritis, 1 SLE, 4 with insufficient data), leaving a total of 78 patients. There was an equal female to male ratio-39 males and 39 females. There were 6 systemic JIA patients (7.69%), 17 persistent oligoarthritis (21.79%), 4 extended oligoarthritis (5.12%), 11 polyarthritis rheumatoid factor (RF) positive (14.10%), 21 polyarthritis RF negative (26.9%), 1 psoriatic arthritis (1.28%), and 18 enthesitis-related arthritis (23%). The median CHAQ for the group was 0.5 (IQR 0.1-1.25), the median VAS for pain was 18 mm (IQR 4-42) and median VAS for general well-being was 25 mm (IQR 3-49). Enthesitis-related arthritis and polyarthritis disease subtypes in this South African population may be more common than seen in JIA populations described in northern Europe, India, United Kingdom, and Turkey. CONCLUSION: This Western Cape South African JIA population appears to have a different profile of JIA than what has been described elsewhere. Enthesitis-related arthritis and polyarthritis disease subtypes appear to be more prevalent. There are also significant challenges in this setting such as later presentation to pediatric rheumatologists, different disease characteristics, and variable disease courses.