Browsing by Subject "Juvenile idiopathic arthritis"

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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.
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    The identification of gait asymmetry in children with juvenile idiopathic arthritis
    (2025) Mpaka, Lindiwe; Kroff, Jacolene; Atterbury, Elizma
    Background: Gait abnormalities are common in children with JIA, and early detection is crucial to reduce walking disability, which is a significant aspect of daily life. Analyzing gait in this population provides vital information about joint issues and walking patterns, guiding treatment goals. Addressing gait asymmetry can enhance a child's functional abilities, participation in activities, and overall quality of life. Purpose: To determine the incidence of gait asymmetry in children with JIA and to further determine the association between gait asymmetry and disease severity and functional capacity Study design: Cross-sectional Observational study. Methods: A total number of 14 children between 6-16 years of age (accompanied by their parents) that are diagnosed with JIA, were recruited. They were recruited between April and October 2023 at Tygerberg Hospital, Bellville, Cape Town during routine medical check-ups. The 6MWT was used to assess gait-related variables using the APDM wearable Technologies® incorporated within the Mobility Lab software package. We focused on the examination of five gait parameters related to the lower limbs: 1) Gait cycle duration, 2) gait speed, 3) time in stance phase, 4) stride length, and 5) time in swing phase. The test was administered in a 25 meters walkway, which was measured using a tape measurer, two cones were placed on each end, one at the beginning and one cone at the end of the distance. Results: We found a statistically significant difference in gait speed and stride length (p=0.031 and p=0.046, respectively) for the total group, considering left and right leg. Gait asymmetry was found in 8 of 14 participants when the effect size was calculated. No significant differences were found when comparing four of the gait variables between the asymmetry and no asymmetry groups. However, a statistically significant difference was observed in stride length (p = 0.04 left and p = 0.03 right) in the asymmetry and no asymmetry group. There was no statistical significance between the disease activity and the asymmetry group (p = 0.627). No statistically significant difference was observed in the total distance achieved in both the asymmetry and no asymmetry group on the 6MWT. Conclusion: Our study underscores the significant impact of gait speed and stride length on gait asymmetry in children with JIA. These gait parameters exhibited the greatest discrepancies among participants, with stride length closely associated with gait asymmetry and gait speed significantly correlated with the total distance achieved during the 6MWT. These findings suggest that both stride length and gait speed are critical factors in understanding gait asymmetry and the functional limitations experienced by children with JIA.