Socio-demographic and clinical aspects of rheumatoid arthritis.

Abstract

OBJECTIVE:

To determine the socio-demographic profiles and some clinical aspects of patients with rheumatoid arthritis (RA).

DESIGN:

Prospective, cross-sectional study.

SETTING:

Ambulatory out- patient clinics of Kenyatta National Hospital (KNH), a public national and referral hospital.

SUBJECTS:

Out of 180 patients interviewed and examined, 60 met American College of Rheumatology (ACR) diagnostic criteria of RA.

RESULTS:

Of the 60 patients recruited 52 (87%) were females with male: female ratio of 1: 6.5. The mean age of patients was 41.38(+/- 16.8) years. There were two peaks of age of occurrence, 20-29 and 40-49 years. In 75% of the study patients, one or more of metacarpophalangeal joints of the hand were involved in the disease. Other frequently involved sites were--wrists, elbows, knees, ankles and glenohumeral joints of shoulders in a symmetrical manner. Serum rheumatoid factor was positive in 78.9% while rheumatoid nodules were present in 13.3% of the study patients. A large majority of patients (88%) had active disease with 18% having mild disease, 38% moderate activity and 32% having severe disease. Only 12% of patients had disease in remission. Forty six point seven per cent (46.7%) of the study patients were on at least one Disease Modifying anti Rheumatic Drugs (DMARD) from a selection of methotrexate, sulphasalazine, hydroxychloroquine and leflunamide. The most frequent drug combination was methotrexate plus prednisolone at 30% of the study population; while 66.7% were on oral prednisolone with 25% of the study patients taking only Non-Steroidal anti Inflammatory Drugs (NSAIDS).

CONCLUSION:

A large majority of ambulatory patients with RA had active disease. Most of them were sub-optimally treated, especially the use of DMARDS. About two thirds were on oral steroids. Sub-optimal therapy in relatively young patients, peak 20-29 and 40-49 years is likely to impact negatively on their disease control and quality of life.

• Authors: B O Owino, G O Oyoo, C F Otieno
• Journal: East African medical journal (East Afr Med J) Vol. 86 Issue 5 Pg. 204-11 (May 2009) ISSN: 0012-835X [Print] Kenya
• PMID: 20084988 (Publication Type: Journal Article)

Chemical References

• Adrenal Cortex Hormones
• Antirheumatic Agents

Topics

• Adolescent
• Adrenal Cortex Hormones (therapeutic use)
• Adult
• Age Distribution
• Aged
• Aged, 80 and over
• Antirheumatic Agents (therapeutic use)
• Arthritis, Rheumatoid (diagnosis, drug therapy, epidemiology)
• Cross-Sectional Studies
• Female
• Humans
• Kenya (epidemiology)
• Male
• Middle Aged
• Prospective Studies
• Risk Factors
• Severity of Illness Index
• Socioeconomic Factors
• Young Adult