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SP0111 Pediatric Rheumatology in the Balkan Area
  1. J. Vojinovic
  1. Department for Pediatric Rheumatology, Clinic of Pediatrics, Clinical Center, Faculty of Medicine University of Nis, Nis, Serbia


Pediatric rheumatic diseases (PRD) include numerous autoimmune, autoinflammatory and not inflammatory conditions in children that contribute substantially number of musculoskeletal diseases in adulthood (estimated to be present in each forth adult European citizen). The prevalence of only inflammatory PRD, based on data from developed nations, is in the range 2-3/1000 children while PRD comprises 0.1% of all-cause mortality in children ages 5-14 years. The European Union has recognized this problem in its European Charter of patients' rights. Organization and funding of Health Care Services and approach to PRD differs substantially throughout Europe, and even within a single country, that is why the international organizations for pediatric rheumatologists in Europe (PReS and PRINTO) have acknowledged this problem and started several networking projects with aim to standardize diagnosis and management of PRD throughout Europe. Balkan is a geographical and cultural region of Southeast Europe (SEE) inhabited with more than 60 million citizens and around 15 million children, living in 9 countries (4 EU members: Bulgaria, Croatia, Greece, Romania; 3 EU candidate countries: Montenegro, Serbia, FYR Macedonia and 2 EU potential candidate countries: Albania, Bosnia and Herzegovina). Despite huge diversity of religion, ethnicity, economy, health service organization and funding considering PRD most of countries are facing same problems: a) absent or inadequate recognition or awareness of PRD by governments, patients and their families; b) late primary care providers referral that foster delays in timely diagnosis; c) inappropriate or outdated perception of outcomes and no availability of medications and diagnostic equipment; d) numerous educational deficiencies and lack of educational standards (big differences in the national training programs, no established national certification recognition and training program for pediatric rheumatology); e) lack of pediatricians with formal pediatric rheumatology education (approximately two to three fold less than in Italy or UK covering same population number); e) lack of national registries for PRD and subsequent epidemiology data; f) lack of funding and organized research initiatives. Recognizing this clear educational and organizational need PReS scientifically endorsed and initiated several educational activities in last several years with prospective to expand these activities in future implementing SHARE project strategy. Educational activities going on are establishment of South-East Europe Postgraduate courses in pediatric rheumatology (hosted each second year in a different country: Romania 2012 and Serbia 2014) and Musculoskeletal Ultrasound (MSUS) courses for pediatric rheumatologists (hosted yearly in a different country: Serbia 2013 and Romania 2014). 21st PReS Congress to be held in Belgrade in September 2014 will additionally improve awareness and knowledge about PRD in region and expand it to rest of South-Eastern Europe parts. One of the idea worth to be implemented could be Balkan regional PRD registry to evaluate epidemiology data and explore reasons for differences in incidence, prevalence and outcome of PRD in this region inhabited with specific mixture of Mediterranean and Eastern Europe nations. There is lot of work and activities to be done to achieve goal that despite their differences, national health systems in European countries has to place the same rights of patients, consumers, users, family members, weak populations and ordinary people at risk.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.6218

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