Global prevalence estimates of three chronic musculoskeletal conditions: club foot, juvenile idiopathic arthritis and juvenile systemic lupus erythematosus

Abstract

Background: Musculoskeletal (MSK) conditions are a major source of morbidity and disability. There is a lack of global comparable data on the burden of MSK conditions in children and young people. Our aim was to estimate the global prevalence of three MSK conditions-Talipes Equinovarus (Clubfoot), Juvenile Idiopathic Arthritis (JIA) and Juvenile Systemic Lupus Erythematosus (JSLE). Methods: Using reported prevalence rates, age-stratified population data within the World Bank Data Bank in 2017 and United Nations country classification, we estimated the prevalence of these MSK conditions in < 5 year olds (clubfoot) and < 16 year olds (JIA and JSLE) across the world. Results: We estimated that in 2017, there were~675,061 < 5 year olds with clubfoot among 675,100,000 < 5 year olds,~2,069,246 < 16 year olds with JIA and~206,931 < 16 year olds with JSLE per 2,069,000,000 < 16 year olds, totalling~2,951,238 with one of these conditions. Disease prevalence was greatest in Asia (South Asia), followed by Africa, Americas, Europe and Oceania. Conclusions: An estimated 3 million children and young people globally are currently living with either clubfoot, JIA or JSLE; many in Asia and Africa. Further work is needed urgently to engage with global stakeholders to work together to improve access to effective care for the many who are affected and reduce the otherwise adverse lifelong impact on their health, quality of life and the impact on society.

Improving musculoskeletal health for children and young people – A ‘call to action’

“…Infectious causes of MSK disability, such as tuberculosis (TB) and septic arthritis disproportionately affect children in LRIC; although MSK TB comprises <10% of active TB cases, with over 10 million cases of active TB per year, the burden is significant, especially in areas where HIV co-infection is common [ 13 ]. There is estimated to be at least 2 million CYP who have one form of arthritis or another [ 28 , 29 ] and many live in the most populated and least well-resourced countries in Asia and Africa [ 29 ]. The WHO estimates 20–50 million people every year are injured in road traffic accidents and these are the leading cause of death for those aged 5–29 years [ 14 , 30 ]; more than 90% of road traffic deaths occur in resource poor countries with highest death rates in Africa.…”

“…Traditional shoe wear is not possible for those with an untreated clubfoot as the affected foot is twisted inwards so weight-bearing actually occurs on the top of the foot. While the incidence of clubfoot is fairly consistent around the world, the burden of clubfoot is disproportionately found in LRIC and MRIC in the most populated countries mostly in Africa and Asia [ 29 ], where 80% of the untreated or neglected clubfeet are located [ 29 , 42 ]. Individuals with clubfoot face incredible hurdles throughout their whole lives with stigma, discrimination, loneliness and being hidden away because the family feel ashamed; they are among the least likely to enjoy the benefits of education and healthcare and even worse, are subject to higher risks of neglect, poverty, physical and sexual abuse [ 44 ].…”

Delivery of paediatric rheumatology care: a survey of current clinical practice in Southeast Asia and Asia-Pacific regions

“…Paediatric rheumatologists also have key roles in education and training leadership, advocacy, policy development and research which are likely to impact on clinical care capacity building. Previous studies from mostly HRIC and MRIC regions demonstrate the global scarcity of paediatric rheumatologists [ 2 , 5 , 6 , 20 – 22 ]; the scarcity is most severe in Africa and Asia, unfortunately in the most populous countries and where there are large numbers of children affected [ 23 ].…”

A Mixed Methods Evaluation of The Paediatric Musculoskeletal Matters (PMM) Online Portfolio

“…E-learning platforms are now increasingly utilised (43) and there is great potential for e-technology and telehealth (44) to reach many users around the world at relatively low cost. This is particularly relevant to the 'PMM portfolio' given the evidence that many CYP with MSK conditions live in parts of the world (Asia and Africa) with little or no access to specialist care (45). Our evaluation and iterative approach highlights the importance of user engagement to optimise reach and impact.…”