1. School of Clinical Medicine, Muhimbili University of Health and Allied Sciences , Dar es salaam, Tanzania
2. Department of Pediatrics, Muhimbili National Hospital , Dar es Salaam, Tanzania
3. School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England , Bristol, UK
4. Rheumatology Department, University Hospitals Bristol and Weston NHS Foundation Trust , Bristol, UK