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Kemta Lekpa F, Eloundou P, Moulion Tapouh JR, Simeni Njonnou SR, Fojo Talongong B, Same Bebey F, Megne Tamo E, Noukeu D, Enyama D, Abouame PH, Sime Tchouamo AA, Namme Luma H, Ngandeu-Singwe M, Choukem SP. Clinical presentation and imaging findings in juvenile-onset back pain: a ten-year hospital-based retrospective analysis in Douala (Cameroon). Front Pediatr 2024; 12:1424391. [PMID: 39015207 PMCID: PMC11250053 DOI: 10.3389/fped.2024.1424391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Accepted: 06/17/2024] [Indexed: 07/18/2024] Open
Abstract
Introduction Studies exploring the clinical and imaging characteristics of juvenile-onset back pain (JOBP) are scarce. The purpose of this study was to assess the clinical presentation, imaging findings, and factors associated with JOBP. Methods A retrospective record-based study was conducted among all pediatric cases presenting to the Rheumatology unit of the Douala General Hospital, Cameroon, from January 2014 to December 2023. The study did not include children whose back pain began after 16 years of age. Results Of the 216 records of patients under 18 examined, 67 children (31 girls) were diagnosed with JOBP. The median age was 15 [13-16] years. More than two-third of the children included in this study had chronic pain (n = 46; 68.65%). Pain was mild to moderate in intensity in 48 children (71.6%). Radiculopathy was present in 10 children (14.92%). The most common location of back pain was the lumbar region (n = 64; 95.52%). Some children experienced pain in more than one location. The location of the pain was not associated with gender, duration of the pain, radiculopathy, or practice of a competitive sport (p > 0.05). Musculoskeletal abnormalities on imaging were found in 38 children (62.29%). In multivariate analysis, peripheral joint involvement [aOR = 0.253 (0.073-0.878); p = 0.030] and mild pain intensity [aOR = 0.077 (0.014-0.422); p = 0.003], were independently associated with the presence of musculoskeletal abnormalities on imaging. Conclusion JOBP affects a third of children and adolescents of our clinic population. The common musculoskeletal abnormalities found on spine imaging are disc diseases and scoliosis.
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Affiliation(s)
- Fernando Kemta Lekpa
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
- Health and Human Development (2HD) Research Network, Douala, Cameroon
| | - Paul Eloundou
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Jean Roger Moulion Tapouh
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
- Health and Human Development (2HD) Research Network, Douala, Cameroon
| | - Sylvain Raoul Simeni Njonnou
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
- Health and Human Development (2HD) Research Network, Douala, Cameroon
| | | | - Francine Same Bebey
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Estelle Megne Tamo
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Diomède Noukeu
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
- Health and Human Development (2HD) Research Network, Douala, Cameroon
| | - Dominique Enyama
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
- Health and Human Development (2HD) Research Network, Douala, Cameroon
| | - Palma Haoua Abouame
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
| | | | - Henry Namme Luma
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | | | - Simeon Pierre Choukem
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
- Health and Human Development (2HD) Research Network, Douala, Cameroon
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Dey D, Sciascia S, Pons-Estel GJ, Ding H, Shen N. Health Disparities in Rheumatic Diseases: Understanding Global Challenges in Africa, Europe, Latin America, and Asia and Proposing Strategies for Improvement. Rheum Dis Clin North Am 2021; 47:119-132. [PMID: 34042051 DOI: 10.1016/j.rdc.2020.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Rheumatic diseases reach across continents with some similarities as well as unique challenges. The intersection between genetic factors, environmental exposures and socioeconomic factors, as well as challenges, with delays in access to subspecialty care and medications, manifest in different ways. By understanding both the challenges and successes in different countries, while also recognizing the significant diversity both within and across continents, unified strategies to improve rheumatic disease outcomes and decrease disparities among the most vulnerable groups can be developed and disseminated.
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Affiliation(s)
- Dzifa Dey
- Rheumatology Unit, Department of Medicine and Therapeutics, Korlebu Teaching Hospital, University of Ghana Medical School, College of Health Sciences, PO Box 4236, Korle-Bu, Accra, Ghana.
| | - Savino Sciascia
- Center of Research of Immunopathology and Rare Diseases- Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, and SCDU Nephrology and Dialysis, Department of Clinical and Biological Sciences, S. Giovanni Bosco Hospital and University of Turin, Piazza del Donatore di Sangue 3, Turin 10154, Italy
| | | | - Huihua Ding
- Shanghai Institute of Rheumatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Nan Shen
- Shanghai Institute of Rheumatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Determinants of Use of Biotherapeutics in sub-Saharan Africa. Trends Pharmacol Sci 2020; 42:75-84. [PMID: 33358177 DOI: 10.1016/j.tips.2020.11.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/24/2020] [Accepted: 11/24/2020] [Indexed: 01/06/2023]
Abstract
Biologic drugs are reshaping clinical practice in various disciplines, even while access to them is imbalanced across global settings. In sub-Saharan Africa, biotherapeutics have potential roles to play in the treatment of a range of conditions that include infectious and noncommunicable diseases (NCDs). However, the literature is scarce on guidance for addressing local access challenges, including technical, regulatory, affordability, and other healthcare delivery aspects. This article aims to assess fundamental determinants of use of biologic medicines in sub-Saharan Africa. The purpose is to inform strategic actions of scientists, physicians, policymakers, and other stakeholders that are working to improve access to innovative therapies in low resource parts of the world.
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Fink D, Oladele D, Etomi O, Wapmuk A, Musari-Martins T, Agahowa E, Ekama S, Okechukwu A, Mallen C, Ezechi O, Salako B. Musculoskeletal symptoms and non-prescribed treatments are common in an urban African population of people living with HIV. Rheumatol Int 2018; 39:285-291. [PMID: 30382343 DOI: 10.1007/s00296-018-4188-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 10/26/2018] [Indexed: 10/28/2022]
Abstract
There are no data from West Africa reporting musculoskeletal (MSK) disease in people living with HIV (PLWH). Our primary outcome was to measure the prevalence of MSK symptoms in PLWH in urban West Africa. Our secondary outcomes were to describe the disability, impact on work and treatment use associated with the presence of MSK pain. We conducted an e-questionnaire-based point prevalence study of musculoskeletal symptoms, associated disability and treatment in 292 PLWH attending routine follow-up in Lagos, Nigeria. Seventy-three (25%) patients reported MSK pain; 28 (38%) reported chronic symptoms (> 3 months). HIV suppression rates were high in this population (n = 240, 82%) and comparable between individuals with and without chronic pain. MSK pain was associated with female gender and higher body mass index (BMI). Mechanical pain was the most common pain syndrome identified (n = 34, 47%). Lumbar spine and knee were the most common sites. Chronic pain was associated with increased disability compared with the presence of any MSK pain. High rates of treatment-seeking behaviour were seen in those individuals reporting MSK pain (n = 62, 85%). The majority of these individuals sought traditional treatments (n = 48, 66%). Chronic MSK pain and non-prescribed treatments are common in PLWH established on ART in urban West Africa. Studies are required to measure the long-term impact of these symptoms and medicines on retention in HIV care and ART adherence, besides other long-term health outcomes.
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Affiliation(s)
- Doug Fink
- Department of Infection and Immunity, Cruciform Building, University College London, Gower Street, London, WC1E 6BT, UK.
| | - David Oladele
- Nigerian Institute of Medical Research (NIMR), Lagos, Nigeria
| | - Oseme Etomi
- Department of maternal medicine, Guy's and St Thomas's NHS Foundation Trust, London, UK
| | - Agatha Wapmuk
- Nigerian Institute of Medical Research (NIMR), Lagos, Nigeria
| | | | | | - Sabdat Ekama
- Nigerian Institute of Medical Research (NIMR), Lagos, Nigeria
| | | | - Christian Mallen
- Arthritis Research UK Primary Care Centre, Keele University, Staffordshire, UK
| | - Oliver Ezechi
- Nigerian Institute of Medical Research (NIMR), Lagos, Nigeria
| | - Babtunde Salako
- Nigerian Institute of Medical Research (NIMR), Lagos, Nigeria
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