Juvenile Idiopathic Arthritis in a Hospital Setting in Chad: A Study of 85 Cases
Abstract
Introduction: Juvenile idiopathic arthritis (JIA) is the most common chronic inflammatory rheumatism in children. It remains poorly studied in sub-Saharan Africa. Objective: To describe the epidemiological, clinical, therapeutic and evolutionary features of JIA in a rheumatology department in Chad. Methods: This was a retrospective descriptive study involving 85 cases of JIA collected from January 2020 to September 2024. Demographic, clinical, biological, therapeutic, and follow-up data were analyzed. Results: Among 111 systemic disease cases, 85 were JIA. The mean age at disease onset was 11.2 years with a female-to-male ratio of 2.4. The most common forms were enthesitis-related arthritis (30.6%), RF-negative polyarthritis (30.6%), and oligoarthritis (18.8%). The average diagnostic delay was 4.2 years. The most frequent extra-articular manifestations were uveitis (15.3%) and lymphadenopathy (5.9%). Treatment included NSAIDs, corticosteroids, methotrexate, and etanercept in four cases. Three deaths were recorded. Outcomes were favorable in most cases, as assessed by CHAQ and JADAS scores. Conclusion: JIA is the most frequent pediatric systemic disease in our setting. Diagnosis remains delayed and access to innovative therapies is limited. Early diagnosis and structured follow-up should be strengthened.
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References
2. El Maghraoui, A. (2014). Arthrite juvénile idiopathique. *La Presse Médicale, 43*, 27–33.
3. Koné-Paut, I. (2003). Approche génétique des pathologies inflammatoires de l’enfant. *Revue du Rhumatisme, 70*, 517–520.
4. Bader-Meunier, B., et al. (2003). Le lupus érythémateux disséminé de l’enfant. *Archives de Pédiatrie, 10*, 147–157.
5. Doualla, B. M., et al. (2014). Les rhumatismes inflammatoires chroniques chez les patients de 0 à 20 ans au Cameroun. *Health Sciences and Disease, 15*(3), 1–4.
6. Diomandé, M., et al. (2016). Juvenile idiopathic arthritis in Abidjan: Report of 17 cases. *British Journal of Medicine and Medical Research, 16*(11), 1–6.
7. Feliho, J. L. (2004). *Arthrite chronique juvénile au Sénégal* (Doctoral dissertation, Université Cheikh Anta Diop).
8. Chipeta, J., et al. (2013). Clinical patterns of juvenile idiopathic arthritis in Zambia. *Pediatric Rheumatology, 11*, 1–6.
9. Sekkali, N., et al. (2010). Le rhumatisme articulaire aigu. *Journal Marocain de Cardiologie*, 28–33.
10. Barsaoui, S. (2005). Rhumatisme articulaire aigu chez l’enfant. *EMC - Pédiatrie, 2*, 243–255.
11. Cotton, A., et al. (2013). *Imagerie musculosquelettique: pathologies générales* (pp. 189–200).
12. Solau-Gervais, E., et al. (2010). Prévalence des AJI dans l’Ouest de la France. *Revue du Rhumatisme, 77*, 55–58.
13. Abdwani, R., et al. (2012). Juvenile idiopathic arthritis in Oman. *Pediatric Rheumatology, 10*(1), 18.
14. Seck, N. B., et al. (2016). Fièvre méditerranéenne familiale: observation sénégalaise. *Annales de Dermatologie et de Vénéréologie.*
15. Prieur, A. M. (1998). *Rhumatologie pédiatrique*. Flammarion Médecine.
16. Beukelman, T., et al. (2011). 2011 ACR recommendations for the treatment of JIA. *Arthritis Care & Research, 63*(4), 465–482.
17. Petty, R. E., et al. (2004). ILAR classification of JIA. *The Journal of Rheumatology, 31*, 390–392.
18. Ravelli, A., et al. (2018). Treat-to-target for JIA. *Annals of the Rheumatic Diseases, 77*, 819–828.
19. Martini, A., et al. (2019). Juvenile idiopathic arthritis classification: quo vadis? *Nature Reviews Rheumatology, 15*(10), 557–565.
20. Hinks, A., et al. (2013). Genetic association in JIA. *Nature Genetics, 45*(6), 664–669.
21. Weiss, P. F. (2015). Diagnosis and treatment of enthesitis-related arthritis. *Current Opinion in Rheumatology, 27*(5), 505–512.
22. De Benedetti, F., et al. (2012). Canakinumab for systemic JIA. *New England Journal of Medicine, 367*, 2396–2406.
23. Ruperto, N., et al. (2012). Tocilizumab in systemic JIA. *New England Journal of Medicine, 367*, 2385–2395.
24. Wulffraat, N., et al. (2000). Efficacy of methotrexate in JIA. *Annals of the Rheumatic Diseases, 59*(7), 540–546.
25. Martini, A. (2012). It is time to rethink juvenile idiopathic arthritis classification. *Annals of the Rheumatic Diseases, 71*(9), 1437–1439.
26. Behrens, E. M., et al. (2007). Macrophage activation syndrome in JIA. *Arthritis & Rheumatism, 56*(11), 3374–3384.
27. Gattorno, M., et al. (2007). Autoinflammatory disorders in children. *Current Opinion in Rheumatology, 19*(5), 615–620.
28. Wallace, C. A., et al. (2008). Juvenile idiopathic arthritis: current treatment and future needs. *The Journal of Rheumatology, 35*(4), 726–728.
29. Nigrovic, P. A., et al. (2010). Efficacy of early aggressive therapy in polyarticular JIA. *Arthritis & Rheumatism, 62*(9), 2581–2591.
30. Ravelli, A., & Martini, A. (2007). Juvenile idiopathic arthritis. *The Lancet, 369*(9563), 767–778.
Copyright (c) 2025 Harine Abdel Aziz Garba, Adama Bah, Ramadhane Bouchrane, Harine Abdel Aziz Hamid, Moustapha Niasse, Diallo Saïdou
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