Medicine Usage in South Africa (MUSA), North-West University (Potchefstroom Campus), Private Bag X6001, Potchefstroom, 2520, South Africa.
Statistics, School of Computer, Statistical and Mathematical Sciences, North-West University (Potchefstroom Campus), Potchefstroom, South Africa.
Rheumatol Int. 2018 May;38(5):837-844. doi: 10.1007/s00296-017-3907-y. Epub 2017 Dec 12.
Little is known about the burden of rheumatoid arthritis (RA) in South Africa. The aim of this study was to establish the prevalence of RA and coexisting chronic disease list (CDL) conditions in the private health sector of South Africa.
A retrospective, cross-sectional analysis was performed on medicine claims data from 1 January 2014 to 31 December 2014 to establish the prevalence of RA. The cohort of RA patients was then divided into those with and those without CDL conditions, to determine the number and type of CDL conditions per patient, stratified by age group and gender.
A total 4352 (0.5%) patients had RA, of whom 69.3% (3016) presented with CDL conditions. Patients had a median age of 61.31 years (3.38; 98.51), and 74.8% were female. Patients with CDL conditions were older than those patients without (p < 0.001; Cohen's d = 0.674). Gender had no influence on the presence of CDL conditions (p = 0.456). Men had relatively higher odds for hyperlipidemia (OR 1.83; CI 1.33-2.51; p < 0.001) and lower odds for asthma (OR 0.83; CI 0.48-1.42; p = 0.490) than women. In combination with hyperlipidemia, the odds for asthma were reversed and strongly increased (OR 6.74; CI 2.07-21.93; p = 0.002). The odds for men having concomitant hyperlipidemia, hypertension, type 2 diabetes mellitus and hypothyroidism were insignificant and low (OR 0.40; CI 0.16-1.02; p = 0.055); however, in the absence of hypothyroidism, the odds increased to 3.26 (CI 2.25-4.71; p < 0.001).
Hypothyroidism was an important discriminating factor for comorbidity in men with RA. This study may contribute to the body of evidence about the burden of RA and coexisting chronic conditions in South Africa.
关于类风湿关节炎（RA）在南非的负担，人们知之甚少。本研究的目的是确定南非私营医疗保健部门 RA 的患病率和同时存在的慢性疾病列表（CDL）条件。
对 2014 年 1 月 1 日至 12 月 31 日的医学索赔数据进行回顾性、横断面分析，以确定 RA 的患病率。然后将 RA 患者队列分为伴有和不伴有 CDL 条件的患者，以确定每个患者的 CDL 条件数量和类型，并按年龄组和性别分层。
共有 4352 名（0.5%）患者患有 RA，其中 69.3%（3016 名）患有 CDL 条件。患者的中位年龄为 61.31 岁（3.38；98.51），74.8%为女性。患有 CDL 条件的患者比没有 CDL 条件的患者年龄更大（p < 0.001；Cohen's d = 0.674）。性别对 CDL 条件的存在没有影响（p = 0.456）。与女性相比，男性发生高血脂的几率较高（OR 1.83；CI 1.33-2.51；p < 0.001），发生哮喘的几率较低（OR 0.83；CI 0.48-1.42；p = 0.490）。与高血脂结合时，哮喘的几率会逆转并大大增加（OR 6.74；CI 2.07-21.93；p = 0.002）。男性同时患有高血脂、高血压、2 型糖尿病和甲状腺功能减退的几率较低且无显著性（OR 0.40；CI 0.16-1.02；p = 0.055）；然而，在没有甲状腺功能减退的情况下，几率增加到 3.26（CI 2.25-4.71；p < 0.001）。
甲状腺功能减退是男性 RA 共病的一个重要鉴别因素。本研究可能有助于丰富南非 RA 负担和同时存在的慢性疾病的证据。
