Socio - demographic and clinical aspects of rheumatoid arthritis
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Date
2009Author
Owino, BO
Oyoo, George O
Otieno, CF
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
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
Citation
B O Owino, G O Oyoo and C F O tieno.Socio - demographic and clinical aspects of rheumatoid arthritis. East A fr Med J. 2009;86:204 - 211 .Publisher
University of Nairobi
Collections
- Faculty of Health Sciences (FHS) [10387]