Rheumatoid Arthritis: Prevalence, Patterns of Presentations and Associated Factors among Arthritis Patients in Military Hospital, Sana'a, Yemen 2019-2021

Abstract

Background: Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by inflammatory arthritis and extra-articular involvement.
Objective: This study aimed to portray the prevalence and associated factors of rheumatoid arthritis among arthritis patients in Military hospital, in Sana’a, Yemen.
Methods: It was a facility-based prospective cohort study. From a total of 650 diagnosed patients, one hundred patients with RA were selected and evaluated. Data was collected using a researcher-administered questionnaire and analyzed by SPSS to compare patterns of presentation of RA and its associations with socio-demographic and clinical characteristics.
Results: In the present study of 650 patients with arthritis, out of 200 diagnosed cases of RA, only 100 patients who completed a routine follow-up were eligible for inclusion. 89% were females and the most frequent age was 31-50 years with age mean of 40.5 ± 15.5 and 60% were from Sana’a. Only 5% of patients had a Family history of RA. The most associated comorbidities were HTN, DM and gout. RF and Anti-CCP were positive among 57% and 98%, respectively. 64% of patients had a normal echo exam, while the most diagnosed disease at echo exam was hypertensive heart disease followed by rheumatic heart disease. Male patients with RA had more than four odds to have another autoimmune disease (OR = 4.87; CI:1.29-18.32; P = 0.011). Most patients with exacerbations showed low Vit D deficiency (80%), UTI (40%), and hypocalcemia (30%).
Conclusion: It was concluded that RA is one of the most common autoimmune diseases among Yemeni arthritis patients and most affected females in the middle ages. Concurrence between RA with other autoimmune diseases was seen especially SLE and hypothyroidism, with most patients presenting with disease exacerbations. HHD and RHD were the most encountered on echo screening. The study recommended standardizing the management of RA cases based on the updated guidelines internationally to decrease exacerbations and raise awareness among doctors and patients about the major exacerbating factors for the disease