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THU0505 Low literacy but not parental smoking or breast feeding worsens outcome in juvenile idiopathic arthritis in a low income population
  1. FAC Rocha1,
  2. JI Vasques1,
  3. LN Rocha1,
  4. MG Aguiar1,
  5. JPE Accioly1,
  6. CN Lechiu1,
  7. LHA Costa1,
  8. MFCD Silva2,
  9. ARX Feitosa2,
  10. HAL Rocha3,
  11. CN Rabelo2
  1. 1Internal Medicine, Universidade Federal Do Ceara
  2. 2Pediatric Rheumatology, Hospital Geral de Fortaleza
  3. 3Health Department, Universidade Federal Do Ceara, Fortaleza - CE, Brazil

Abstract

Background JIA data from underdeveloped regions are scant. We evaluated JIA patients living in low latitude (3o43'S), highly exposed to sunlight. We have shown their mean serum vitamin D levels as the higher ever reported, being not associated to disease status. Here are data on monthly income, breastfeeding, parental smoking, and literacy in this JIA cohort.

Methods Clinical and demographic data [n (%)] from 165 JIA patients followed between May 2015 - Dec 2016 in two reference outpatient centers in Fortaleza-CE Brazil were consecutively collected. Family income (more or less than 300 US$/month), breast feeding (more or less than 3 months), literacy [more or less than 8 school-years (SY)], and parental smoking (present/absent) were compared using Juvenile Arthritis Disease Activity Score (JADAS27), Childhood Health Assessment Questionnaire (CHAQ) and presence of deformities as prognostic outcomes.

Results Mean age was 14±4.9 years with 94 (56.9); 63 (38), 40 (24), 37 (22.4), 19 (11.5), 5 (3), and 1 (0.6) of the polyarticular, enthesitis-related, oligoarticular, systemic, undifferentiated, and psoriatic categories, respectively. Mean total CHAQ was 0.4±0.58 with a trend to be higher in polyarticular (0.55±0.69) than oligoarticular (0.3±0.4) category as well as higher JADAS 27 and more deformities in the former. Among 97 respondents, all but one patient was ever breastfed with 71 (73) for more than 3 months; 15 (17) out of 86 mothers were smokers and 28 (33.7) out of 83 smoked among family respondents; 49 (56.3) out of 87 parents had less than 8 SY and only 3 had superior level; 32 (37.6) out of 85 respondents earned less than 300US$. Lower literacy was associated to worse CHAQ (p=0.021). Neither maternal/family smoking nor breastfeeding time was associated to outcome. Lower income per se did not affect outcome.

Conclusions This is the largest JIA database coming from an equatorial region reporting social and environmental aspects. Low literacy predominates, meaning more than half with less than elementary school, affecting prognosis. There is a low income profile and most family constituents do not smoke. Different from other countries, polyarticular category prevails despite low mean CHAQ vis-à-vis data from wealthy regions. Breast feeding for more than 1 month is almost universal and having breastfed for more than 3 months did not appear to influence prognosis

Acknowledgements Conselho Nacional de Desenvolvimento Científico e Tecnolόgico - CNPq - Grant 459334/2014–0

Disclosure of Interest None declared

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