Table 5 Quality Assessment of Articles Selected – Demographics Results
From: Epidemiology and demographics of juvenile idiopathic arthritis in Africa and Middle East
Sr. No. | Reference | Country | Study Design | N (no. of cases) | Classification Criteria | Time Period | Limitations |
|---|---|---|---|---|---|---|---|
Regional | |||||||
1 | Consolaro et al., 2019 [22] | Africa and Middle East | Retrospective chart review with prospective cross-sectional questionnaire | 1209 | ILAR | 2011-2016 | •There was disproportionate number of patients included from various geographical areas •Potential underrepresentation of milder forms of JIA and referral bias •Wide variation in tests and evaluation can affect evaluations or tests •Some countries could not be included •Method of grouping some countries in a particular geographical area was arbitrary •Wide variation in healthcare resources across countries |
2 | Al-Mayouf et al., 2021 [28] | Arab (Saudi Arabia, Libya, United Arab Emirates, Jordan, Oman, Egypt, Kuwait) | Retrospective chart review with prospective disease activity and disease assessment | 702 | ILAR | 2010-2019 | •It was a cross-sectional analysis •There is a possibility of patients •selection bias as the participating centers did not enroll the same number of patients •Wide variation in healthcare resources across countries |
Country | |||||||
3 | Khuffash et al., 1988 [13] | Kuwait | Hospital, consultations | 41 | ARA | 1978-1987 | •10-year study period •ACR criteria utilized •Potential referral bias of more severe cases specifically systemic JIA |
4 | Khuffash et al., 1990 [14] | Kuwait | Hospital, medical records revised by experts, hospital attendance | 108 | ARA | 1981-1988 | •Retrospective •Large population cohort •Possible underestimation of undiagnosed cases in the community and nonreferral by primary care practitioners •Children aged between 12 and 16 years were excluded. •Female children possibly underrepresented •No current data is available |
5 | Abdwani et al., 2015 [11] | Oman | Retrospective, Hospital, medical records, multicentre | 107 | ILAR | 2004-2013 | •Retrospective •10-year study duration •Potential underestimation, only children <13 years of age were included •Potential referral bias, study might have missed on milder cases |
6 | Ozen et al., 1998 [15] | Turkey | Community based survey (parent questionnaire, clinical exam in homes) | 30 | EULAR | 1997 | •Community-based study from 5 districts in turkey •Possible Exclusion of undiagnosed cases not identifiable from questionnaires may have led to possible underestimation |
7 | Abou El-Soud et al., 2013 [12] | Egypt | Population based in Sharkia Governate prospective study, with retrospective chart review | 132 | ILAR | 2009-2010 | •First population-based study from Sharkia governate •Large population cohort included 19 districts •Possible underestimation of numbers due to undiagnosed cases in the community and nonreferral from primary care practitioners |
8 | Furia et al., 2020 [47] | Tanzania | Retrospective hospital chart review | 28 | EULAR | 2012-2019 | •Single centered study •Retrospective study •Possible referral bias and underestimation of milder forms of disease |
9 | Aiche et al., 2018 [31] | Algeria | Cross sectional survey parent/PRO | 70 | ILAR | 2012-2013 | •The objective of the study was to cross-culturally adapt and validate child/adult version of the Juvenile Arthritis Multidimensional Assessment Report (JAMAR) in JIA patients •Possible selection bias •Only selected centers were invited to participate |
10 | Al Marri et al., 2017 [32] | Saudi Arabia | Prospective record review | 23 | ILAR | 1990-2015 | •Potential referral bias could have caused the overall frequency of familial JIA and recurrence risk •Heterogeneous patients were included and were not compared with controls |
11 | Al-Mayouf et al., 2018 [35] | Saudi Arabia | Cross sectional survey parent/PRO | 100 | ILAR | 2012-2016 | •The objective of the study was to cross-culturally adapt and validate child/adult version of the Juvenile Arthritis Multidimensional Assessment Report (JAMAR) in JIA patients Possible selection bias •Only selected centers were invited to participate |
12 | Salah et al., 2009 [63] | Egypt | Retrospective hospital chart review | 196 | ILAR | 1990-2006 | •Single center tertiary hospital study •Higher frequency of oligoarticular JRA, polyarticular and systemic onset JRA could be due to referral bias to tertiary care facilities |
13 | Al-Abrawi et al., 2018 [33] | Oman | Cross sectional survey parent/PRO | 57 | ILAR | 2012-2013 | •The objective of the study was to cross-culturally adapt and validate child/adult version of the Juvenile Arthritis Multidimensional Assessment Report (JAMAR) in JIA patients •Possible selection bias •Only selected centers were invited to participate |
14 | Demirkaya et al., 2018 [45] | Turkey | Cross sectional survey parent/PRO | 466 | ILAR | 2012-2014 | •The objective of the study was to cross-culturally adapt and validate child/adult version of the Juvenile Arthritis Multidimensional Assessment Report (JAMAR) in JIA patients •Possible selection bias •Only selected centers were invited to participate |
15 | El Miedany et al., 2018 [46] | Egypt | Cross sectional survey parent/PRO | 100 | ILAR | 2014-2015 | •The objective of the study was to cross-culturally adapt and validate child/adult version of the Juvenile Arthritis Multidimensional Assessment Report (JAMAR) in JIA patients •Possible selection bias •Only selected centers were invited to participate |
16 | Hashad et al., 2018 [48] | Libya | Cross sectional survey parent/PRO | 100 | ILAR | 2014-2015 | •The objective of the study was to cross-culturally adapt and validate child/adult version of the Juvenile Arthritis Multidimensional Assessment Report (JAMAR) in JIA patients •Possible selection bias •Only selected centers were invited to participate |
17 | Oyoo et al., 2016 [55] | Kenya | Retrospective hospital chart review | 68 | ILAR | 2009-2016 | •Single center tertiary hospital study •Center covers patients from all over Kenya, greater East and Central African region •RF positive polyarthritis patients may be overrepresented which were classified using only one positive assay •Possible underrepresentation of RF negative polyarthritis •Potential referral bias of severe forms of the disease |
18 | Scott et al., 2018 [57] | South Africa | Cross sectional survey parent/PRO | 91 | ILAR | 2013-2016 | •The objective of the study was to cross-culturally adapt and validate child/adult version of the Juvenile Arthritis Multidimensional Assessment Report (JAMAR) in JIA patients •Possible selection bias •Only selected centers were invited to participate |
19 | Sen et al., 2015 [58] | Turkey | Retrospective hospital chart review | 213 | ILAR | 1998-2013 | •Single center study •The collected data may be incomplete and incorrect due to the retrospective study design •HLA-B27 test was not done for all patients |
20 | Shafaie et al., 2018 [59] | Iran | Cross sectional survey parent/PRO | 102 | ILAR | 2012 | •The objective of the study was to cross-culturally adapt and validate child/adult version of the Juvenile Arthritis Multidimensional Assessment Report (JAMAR) in JIA patients •Possible selection bias •Only selected centers were invited to participate |
21 | Yener et al., 2020 [61] | Turkey | Retrospective hospital chart review | 116 | ILAR | 2012-2018 | •Single center study •Retrospective cohort study •The study included lower number of patients as compared to other studies conducted in the country |
22 | Çakan et al., 2017 [41] | Turkey | Retrospective hospital chart review | 265 | ILAR | 2010-2016 | •Single center study •The study included lower number of patients •Short follow-up time |
23 | Kasapçopur et al., 2004 [51] | Turkey | Retrospective hospital chart review | 198 | ILAR | NA | •Single center study •Study conducted to determine frequency of ANA positivity and uveitis in newly diagnosed JIA patients |
24 | Ozdogan et al., 1991 [56] | Turkey | Retrospective hospital chart review | 147 | EULAR/WHO | 1980-1988 | •Single center study •Potential referral bias of milder forms of comorbidities such as uveitis |
25 | Abdul-Sattar et al., 2014 [30] | Egypt | Cross sectional Medical chart review, school attendance records, HRQOL questionnaire | 52 | ILAR | 2011-2013 | •Single center study •Included patients aged 7-17 years diagnosed to ILAR criteria •Study aimed to investigate JIA patients school absenteeism and school functioning •Potential selection and referral bias •Cross-sectional study design limits the ability to determine temporal relationships between risk factors and both of school absenteeism and of poor school functioning |
26 | Abdul-Sattar et al., 2014 [29] | Egypt | Medical chart review, Health related quality of life (HRQoL) questionnaire | 58 | ILAR | 2010-2012 | •Single center study •Included patients aged 8-18 years diagnosed to ILAR criteria •Small study sample •Study aimed to identify determinants of impaired HRQOL in children with JIA •Cross-sectional design limits the ability to determine temporal relationships between risk factors and HRQOL |
27 | Albokhari et al., 2019 [36] | Saudi Arabia | cross sectional health related quality of life survey | 44 | ILAR | 2017 | •Single center study •Study aimed to evaluate effect of JIA on HRQOL •Single center study •Potential referral bias and over representation of more severe forms |
28 | Al-Hemairi et al., 2015 [34] | Saudi Arabia | Retrospective hospital chart review | 82 | ILAR | 2007-2015 | •Retrospective record-based study •Single centered •Small sample size •Diagnosis was confirmed by pediatric rheumatologist |
29 | Amine et al., 2009 [38] | Morocco | Health related quality of life (HRQoL) survey | 80 | ILAR | 2006-2007 | •The aim of the study was to assess HRQoL- related impact of JIA •Demographics, subtype, clinical and lab parameters were obtained for patients •Potential selection and referral bias over-representation of severe forms |
30 | Bahabari et al., 1997 [39] | Saudi Arabia | Retrospective hospital chart review with prospective follow-up | 115 | ACR | 1978-1993 | •Multi-center study •18 months follow up •Potential referral bias and under representation of milder forms |
31 | Bouaddi et al., 2013 [40] | Morocco | Cross-sectional prospective | 33 | ILAR | 2013 | •Aim of the study was to assess the impact of JIA on schooling •Single center •Case control •Small sample size |
32 | Chipeta et al., 2013 [42] | Zambia | Retrospective hospital chart review | 78 | EULAR/ILAR | 1994-1998 and 2006-2010 | •Single center •Potential referral bias •Two different classifications were used for each study period •1994-1998 EULAR •2006-2010 ILAR •ANA test was not routinely available |
33 | Hussein et al., 2018 [49] | Egypt | Retrospective hospital chart review with prospective follow-up | 63 | ILAR | 2004-2010 | •Single center •Cross sectional design |
34 | Olaosebikan et al., 2017 [54] | Nigeria | Retrospective hospital chart review | 28 | not specified | 2010-2016 | •Single center •Patients referred to adults rheumatologists due to lack of pediatric rheumatology service •The study included all types of pediatric rheumatology patients, hence unreliable representation of JIA demographics |
35 | Weakley et al., 2012 [60] | South Africa | Prospective cross sectional | 78 | ILAR | 2010-2011 | •Small sample size •Sample bias •Mutli-center |
36 | Mostafa et al., 2019 [53] | Egypt | Cross sectional HRQol and functional disability questionnaire | 48 | ILAR | 2018 | •Aim of the study was to assess functional disability in JIA patients •Single-centered •Potential referral bias and underrepresentation of milder forms |
37 | Dagher et al., 2014 [43] | Lebanon | Retrospective chart review | 66 | ILAR | 2010-2014 | •Single center •Potential referral bias |
38 | Khawaja et al., 2017 [52] | UAE | Retrospective hospital chart review ICD codes | 66 | ILAR | 2011-2014 | •Aim of the study was to assess access to care for JIA patients amongst local and non-local population •Potential referral bias •Selection bias |
39 | Alzyoud et al., 2020 [37] | Jordan | Retrospective hospital chart review | 210 | ILAR | 2015-2019 | •Single center •Potential referral bias •Patients above 14 years of age were not included |
40 | Demirkaya et al., 2011 [44] | Turkey | Retrospective cross sectional from registry | 634 | ILAR | 2008-2009 | •Multi-center •Registry is not representative of all centers from Turkey |
41 | Karadag et al., 2020 [50] | Turkey | Retrospective hospital chart review with prospective data collection | 281 | ILAR | 2018-2019 | •Retrospective chart review •1-year study duration, some patients did not have final diagnosis confirmed •Single center •Potential referral bias |
42 | Yilmaz et al., 2008 [62] | Turkey | Retrospective chart review | 196 | ILAR | 1995-2004 | •Hospital based •Single center •Referral bias may explain low prevalence of oligoarticular JIA and low uveitis |