African recommendations for diagnosis and management of systemic juvenile idiopathic arthritis (sJIA) – a PAFLAR initiative

To develop evidence-based recommendations for diagnosis and treatment of children and adolescents with systemic juvenile idiopathic arthritis (sJIA), taking into consideration the socioeconomic status and availability of medications in African countries. A steering group composed of five PAFLAR members formulated questions in PICO format (Patient/Population, Intervention, Comparison, Outcome), conducted a systematic literature review, and identified experts in pediatric rheumatology throughout Africa. The Delphi method was used to reach consensus among the experts on the recommendations for diagnosis and treatment of sJIA patients. The online Delphi questionnaire was sent to the 22 experts selected by the steering committee, who were asked to vote for each statement and to provide their suggestions for modifications or rewording. A 100% response rate was obtained. A minimum agreement of 70% among the voting panel was required. A total of 15 recommendations were formulated, 4 regarding diagnosis and 11 regarding treatment. The percentage of agreement with the recommendations ranged from 72.7% to 95%. We present the first African recommendations for diagnosis and management of sJIA. The feedback about the application of these recommendations in pediatric rheumatology centers will serve as the basis for future revisions in the light of African-specific experiences and insights.

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Publication Details

Journal
Pediatric Rheumatology
Published
2026-10-13
DOI
https://doi.org/10.1186/s12969-026-01238-z
Primary Topic
Autoimmune and Inflammatory Disorders Research
Type
article
Field-Weighted Citation Impact
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article

African recommendations for diagnosis and management of systemic juvenile idiopathic arthritis (sJIA) – a PAFLAR initiative

Yasmine Makhlouf, Wafa Hamdi, Yaninga Halwani Fuseini, Elisa Palalane et al.
Pediatric Rheumatology
Autoimmune and Inflammatory Disorders Research
article

African recommendations for diagnosis and management of systemic juvenile idiopathic arthritis (sJIA) – a PAFLAR initiative

Yasmine Makhlouf, Wafa Hamdi, Yaninga Halwani Fuseini, Elisa Palalane, ANGELA NYANGORE MIGOWA, Samy Slimani, Wassila Messadi, Ahmed Seri, Hanna Lishan Kassa, Ali Sobh, Djohra Hadef, Ayodele Faleye, Christiaan Scott, Pierre Quartier, Madeleine Ngandeu, Mohammed Hassan, Eman A. Almsillati, Ourida Gacem, Doaa Mosad, Angelo Ravelli, Hala Etayari, Waleed Hassan, Soad Hashad, Yassmin Taha, Hanane Lassoued Ferjani, Chafia Makhloufi Dahou, Temesgen Teferi, Samah Ismail
article en

Abstract

To develop evidence-based recommendations for diagnosis and treatment of children and adolescents with systemic juvenile idiopathic arthritis (sJIA), taking into consideration the socioeconomic status and availability of medications in African countries. A steering group composed of five PAFLAR members formulated questions in PICO format (Patient/Population, Intervention, Comparison, Outcome), conducted a systematic literature review, and identified experts in pediatric rheumatology throughout Africa. The Delphi method was used to reach consensus among the experts on the recommendations for diagnosis and treatment of sJIA patients. The online Delphi questionnaire was sent to the 22 experts selected by the steering committee, who were asked to vote for each statement and to provide their suggestions for modifications or rewording. A 100% response rate was obtained. A minimum agreement of 70% among the voting panel was required. A total of 15 recommendations were formulated, 4 regarding diagnosis and 11 regarding treatment. The percentage of agreement with the recommendations ranged from 72.7% to 95%. We present the first African recommendations for diagnosis and management of sJIA. The feedback about the application of these recommendations in pediatric rheumatology centers will serve as the basis for future revisions in the light of African-specific experiences and insights.

Pediatric Rheumatology
Suez Canal University (EG), Hôpital Necker-Enfants Malades (FR), Université de Yaoundé I (CM), Haramaya University (ET), University of Ottawa (CA), Mansoura University (EG), University of Batna 1 (DZ), University of Algiers Benyoucef Benkhedda (DZ), Université Paris Cité (FR), Benha University (EG), Tanta University (EG), University of Tripoli (LY), Aga Khan University Hospital Nairobi (KE), Tamale Teaching Hospital (GH), Istituto Giannina Gaslini (IT), Children's Hospital Mansoura University (EG), Mansoura University Hospital (EG), Assistance Publique – Hôpitaux de Paris (FR), University of Algiers 3 (DZ), Aga Khan University Nairobi (KE), Lagos State University Teaching Hospital (NG), Maputo Central Hospital (MZ), University Teaching Hospital of Yaounde (CM), Centre Hospitalo-Universitaire Bab El Oued (DZ), Institut des Maladies Génétiques Imagine (FR), University of Batna 2, Addis Ababa University (ET), Tunis El Manar University (TN), Manouba University (TN)
Openalex Percentile: Top 13%
Autoimmune and Inflammatory Disorders Research
DOIOpen Access PDFOpenAlex
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