Editorial: "Promoting Patient-Centered Care for Pediatric Rheumatology Across Africa"

Wafa Hamdi^1*Angela Migowa²

• ¹Department of rheumatology Kassab Institute UR17SP04, Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia
• ²Department of Paediatrics and Child Health, Medical College of East Africa, Aga Khan University, Nairobi, Kenya

that explores the experiences of parents caring for children with JIA at a tertiary referral hospital. Through in-depth interviews, the study identifies eight major challenges: medicalrelated difficulties, emotional distress, coping mechanisms, financial constraints, social challenges, interactions with healthcare personnel, and work-life disruptions. The findings highlight the critical need for a holistic, patient-centered approach that not only addresses the medical needs of children with JIA but also provides structured support for caregivers. Enhancing access to resources, developing targeted interventions, and increasing awareness among healthcare providers about the impact of JIA are essential steps toward improving outcomes for both patients and their families.experience to improve healthcare. Thereby, the realities of clinical practice can sometimes be difficult to confront, particularly when it comes to delayed diagnoses in pediatric rheumatology. A striking case report from Bouaké, Ivory Coast, highlights the diagnostic challenges of JSLE, illustrating a 12-year journey before an accurate diagnosis was established. Initially misdiagnosed as malaria, sickle cell disease, and tuberculosis, the patient endured years of untreated disease activity, leading to severe complications. The diagnosis at the age of 17, underscores the urgent need for increased clinical suspicion, enhanced physician training, and improved diagnostic infrastructure in African healthcare settings. This case serves as a powerful reminder that early recognition and timely intervention are critical in preventing disease progression and reducing morbidity. Addressing these challenges can pave the way for better pediatric rheumatology care and improved patient outcomes across the continent.Pathway for Pediatric Rheumatology. In fact, Nigeria's pediatric rheumatology landscape has witnessed gradual progress, yet significant gaps remain. This review provides a comprehensive look at the field's development, challenges, and future direction. While Lagos has made strides with the establishment of a dedicated pediatric rheumatology unit, specialized services remain scarce across most Nigerian states. Key obstacles identified in this review include low disease awareness, high diagnostic costs, a shortage of trained specialists, and limited research data. Addressing these challenges requires strategic investment in pediatric rheumatology training programs, expansion of specialized care units, and nationwide awareness campaigns.Essential Data with Clinical Implications. Thus, back pain in children and adolescents is often underestimated, yet it can serve as an early indicator of underlying rheumatic conditions (5). A retrospective study conducted in Douala, Cameroon, provides a decade-long overview of juvenile-onset back pain (JOBP), analysing clinical presentation and imaging findings. Among the 67 children diagnosed with JOBP, chronic mechanical lumbar pain was the most prevalent, related with imaging abnormalities such as disc disease and scoliosis. This study offers valuable long-term epidemiological data grounded in everyday clinical experience, reinforcing the need for early musculoskeletal assessment in pediatric patients with persistent back pain. These insights are crucial for shaping diagnostic strategies, improving clinical management, and guiding future research in pediatric rheumatology.In fact, accurate assessment tools are crucial for monitoring disease progression in JIA, especially in cases involving the hip joint. A Tunisian study in our collection examined the applicability and reliability of two hip scoring systems commonly used in pediatric rheumatology practice (6,7). The results showed moderate to good reliability in evaluating joint space narrowing, erosion, and growth abnormalities. However, certain parameters, such as subchondral cysts and sclerosis, revealed poor concordance among observers. Significantly, the study found that targeted training led to improved agreement in some areas, underscoring the need for standardized training for pediatric rheumatologists before these tools can be broadly implemented in clinical practice. This research emphasizes the importance of collaborative studies and standardized methodologies in strengthening the pediatric rheumatology research network.This collection of studies highlights the progress, challenges, and opportunities in pediatric rheumatology across Africa. From caregiver burdens and diagnostic hurdles to the implementation of innovative Therapeutic Patient Education (TPE) and educational programs, each contribution deepens our understanding of the field. Looking ahead, enhanced training, increased research collaboration, and patient-centered strategies will be essential for improving outcomes for children with rheumatic diseases across the continent. This collection serves as a call to action for healthcare providers, policymakers, and researchers to address existing gaps and drive meaningful change in pediatric rheumatologic care, moving towards a more effective and patient-centred approach.