Access to pediatric rheumatology care - A major challenge to improving outcome in juvenile idiopathic arthritis

Juvenile idiopathic arthritis (JIA) is a heterogeneous group of diseases and is one of the most common chronic rheumatic diseases in children. Improving the outcome for children with JIA remains an important goal, with current management of severe JIA involving increasingly aggressive immunosuppressive agents.

Undoubtedly, improving outcome in JIA depends on the availability of effective treatments, but if a child presents late in their disease course or receives inappropriate treatment or does not have access to treatment at all, then outcome is likely to be suboptimal. There is an increasing body of evidence that many children with JIA have a prolonged interval from disease onset to pediatric rheumatology care, and despite there being no published data from developing countries, anecdotal observations suggest that poor access to optimal care is likely to be a global issue.