Paediatric Rheumatology Care in Africa: Hope and Resilience

By Danélia Botes

July 18, 2024

Introduction

Paediatric rheumatology remains a critical yet often overlooked field in Africa. The Paediatric Society of the African League Against Rheumatism (PAFLAR) is at the forefront to address the critical need for specialised care in paediatric rheumatology. Their mission is to enhance awareness, diagnosis, and treatment of paediatric rheumatic diseases across the continent. The team is dedicated to improving the lives of children affected by rheumatic diseases, particularly Juvenile Idiopathic Arthritis (JIA).

The Impact of Dr. Ayodele Faleye’s Work

Dr. Ayodele Faleye has significantly contributed to paediatric rheumatology in Nigeria. Her journey began with a passion for addressing the misdiagnosis of rheumatic diseases in children. Often, these conditions were mistaken for malaria or sepsis. She remains committed to dispelling myths and educating families about paediatric rheumatic diseases. “One of the myths is that children do not have chronic arthritis; it’s been perceived as a disease of adults, especially elderly women,” she explains. One notable case involved a 13-year-old girl with sickle cell anaemia. Initially, her condition was misdiagnosed, leading to numerous blood transfusions. Dr. Faleye identified the correct diagnosis—juvenile systemic lupus erythematosus (JSLE).

A new paediatric rheumatology clinic in Lagos as well as access to serology investigations and treatment such as biologics have made a massive impact on this community in Nigeria. Dr. Faleye also emphasises the need for a multidisciplinary approach including psychologists, occupational therapists, and social workers. Despite numerous successes, Dr. Faleye faces significant challenges, including late presentations, financial constraints, and limited medication availability.

Dr. Freddie Coker: Championing Paediatric Rheumatology in Sierra Leone

Dr. Freddie Coker is another important figure in paediatric rheumatology. His work in Sierra Leone focuses on raising awareness and improving care for children with rheumatic conditions. Dr. Coker’s journey began with his medical education at the University of Sierra Leone and continued with postgraduate training in Ghana. Dr. Coker faced numerous challenges, including a lack of resources and awareness. However, his collaboration with PAFLAR has brought significant progress.

His efforts have led to an increase in referrals for suspected rheumatologic cases, demonstrating growing awareness among healthcare professionals. His leadership within the Sierra Leone Medical and Dental Association (SLMDA) has further amplified his impact, allowing him to influence policy and drive systemic change. In 2023, Dr. Coker successfully ran a media campaign for World Arthritis Day. This initiative attracted more healthcare professionals to the cause and increased referrals for paediatric rheumatology conditions.

Empowering Patients Across Africa

PAFLAR’s Therapeutic Patient Education (TPE) workshops have served as a source of optimism across Africa. Conducted in Kenya, Tunisia, and Nigeria, these workshops have empowered patients and caregivers through engaging educational exercises. In Kenya, the Aga Khan University hosted the forum, while in Tunisia, seasoned doctors led the efforts. In Nigeria, Dr. Ayodele Faleye’s leadership resulted in a remarkable turnout, highlighting the potential for patient education.

These workshops have been vital in imparting crucial knowledge about rheumatological conditions, treatments, and self-management. They have also served as invaluable educational platforms for parents, caregivers, and guardians, fostering a collective understanding of patients’ needs. International researchers and clinicians submitted abstracts of their latest studies for the congress with 75 abstracts being published.

Highlights from the 2023 Hybrid Congress

The 2023 PAFLAR Congress, themed “Paediatric Rheumatology in Africa: Tackling Emerging Challenges,” was a significant milestone. It addressed recent innovations, the use of social media in paediatric rheumatology, patient support groups, and patient-centred care. The hybrid format united healthcare professionals and stakeholders worldwide. It featured 35 lectures over two days, attracting participants from across Africa and beyond. Workshops provided hands-on learning experiences, including musculoskeletal ultrasonography. PAFLAR partnered with Cincinnati Children’s Hospital and other institutions to deliver these sessions. Partner organisations, including Tin Soldiers, increased their visibility and secured potential partnerships at the booth exhibition.

Conclusion

Even though the path to advancing paediatric rheumatology treatment in Africa is filled with obstacles, the dedication of passionate individuals and partners offer hope. PAFLAR is making great progress in redefining the current state of paediatric rheumatology through the use of awareness, education, and collaboration within the scientific community. Collectively, we can focus on better outcomes and ensuring the well-being of all children is not impaired by rheumatic disorders.

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