RESEARCH - Visiting consultant clinics to study prevalence rates of juvenile RA and childhood SLE across dispersed geographic areas

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J Rheumatol. 2007 Feb;34(2):425-9.

Visiting consultant clinics to study prevalence rates of juvenile

rheumatoid arthritis and childhood systemic lupus erythematosus across

dispersed geographic areas.

Kurahara DK, Grandinetti A, Fujii LL, Tokuda AA, Galario JA, Han MJ,

Terrell MJ, Yamamoto KS, Yamaga KM, Person DA.

Department of Pediatrics, University of Hawaii- A. Burns School of

Medicine and Kapi'olani Medical Center for Women and Children,

Honolulu, Hawaii, USA.

OBJECTIVE: Visiting consultant clinics (VCC) may provide pediatric

rheumatologic care to children in rural populations, but the clinical

demands have not been studied. We studied whether these clinics could

be effective in determining prevalence rates of rheumatic illness like

juvenile rheumatoid arthritis (JRA) and childhood systemic lupus

erythematosus (SLE) across large dispersed geographic areas.

METHODS: The study population included children diagnosed with JRA or

SLE at the only civilian pediatric rheumatology center in the State of

Hawaii. Prevalence rates of these illnesses were then calculated for

the urban and more rural neighbor island areas. VCC and prevalence

data were calculated over a 10-year period.

RESULTS: We found a lower prevalence of JRA in the urban area (38.3

per 100,000) when compared to the rural neighbor islands (63.2 per

100,000). However, an equivalent prevalence of SLE was found in the

urban (24.0 per 100,000) and neighboring islands (21.8 per 100,000).

Clinical demands increased significantly with the success of the VCC,

and with an increase in pediatric rheumatologic staffing.

CONCLUSION: We found an increased prevalence of JRA in rural areas

when compared to urban areas. Similar prevalence rates of SLE

suggested the finding was not due to referral bias alone. VCC are

useful to estimate disease prevalence over large areas, and therefore

make it possible to identify areas at greater risk. Further

investigations are needed to elucidate the possible environmental and

genetic factors that may explain the regional differences in JRA

prevalence.

PMID: 17295431

http://www.ncbi.nlm.nih.gov/pubmed/17295431

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