Document Detail


Socio-demographic and clinical aspects of rheumatoid arthritis.
MedLine Citation:
PMID:  20084988     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  East African medical journal     Volume:  86     ISSN:  0012-835X     ISO Abbreviation:  East Afr Med J     Publication Date:  2009 May 
Date Detail:
Created Date:  2010-01-20     Completed Date:  2010-03-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372766     Medline TA:  East Afr Med J     Country:  Kenya    
Other Details:
Languages:  eng     Pagination:  204-11     Citation Subset:  IM    
Affiliation:
Kenyatta National Hospital, P.O. Box 20723-00202, Nairobi, Kenya.
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MeSH Terms
Descriptor/Qualifier:
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
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Antirheumatic Agents

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