Buckman Tonnies Abeku, Sakyi Samuel Asamoah, Yeboah-Mensah Kwame, Antwi Maxwell Hubert, Darban Isaac, Owusu-Brenya Lawrence, Yorke Joseph, Boateng Andy Opoku, Senu Ebenezer, Dompreh Albert, Addei Akwasi Minnah, Boateng Richard, Yankey Ortis, Tandoh Samuel
Department of Medical Laboratory Science, KAAF University College, Buduburam-Gomoa East District, Ghana.
Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Int J Rheumatol. 2024 Jan 12;2024:6639079. doi: 10.1155/2024/6639079. eCollection 2024.
Rheumatoid arthritis (RA) is one of the frequent chronic, systemic, inflammatory autoimmune disorders with an estimated global prevalence of 1%. RA leads to joint destruction and disability if left untreated. Ghana has seen very few studies on RA, and little is known about the disease's severity and related variables. This study sought to characterize the clinical presentation and determine disease severity and associated risk factors with disease severity among RA patients in a tertiary hospital in Ghana.
This cross-sectional study was conducted between September 2020 and August 2021. This study included 56 consecutively consenting RA patients from the Komfo Anokye Teaching Hospital orthopaedic unit. Diagnosis of RA was based on the updated American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) 2022 rheumatoid arthritis classification criteria by a rheumatologist. A study questionnaire was used to gather participant demographics and clinical features, and results from the laboratory were taken from the patients' charts and medical records. The patients' disease severity was evaluated based on the rheumatoid arthritis disease activity score, which is based on a 28-joint count (DAS28), and their functioning was evaluated using the modified health assessment questionnaire.
The participants' mean age was 51.25 ± 13.22 years. Out of the total participants, 46 were females, and 10 were males (female-to-male ratio 4.6 : 1). Moreover, 37.50% had arthritis of the hand; 5.30% had severe disease, and 94.60% were not severe. A majority (76.80%) were on methotrexate medication. The most frequently involved joints were the knee (42.90%), wrist (32.10%), and elbow (12.50%). There was no statistically significant association with disease severity and a functional status score of >0.5 (cOR: 10.60, 95% CI (0.52-217.30); = 0.124). In addition, marital status ( = 0.04), disease duration ( = 0.04), family complaints ( = 0.02), and ESR ( = 0.03) were significantly associated with disease severity.
RA is predominant among elder populations and females. Disease duration, family complaints, and ESR are associated with disease severity. The findings of this study call for interventions towards ensuring early diagnosis of RA among high-risk populations to enhance good management practices.
类风湿关节炎（RA）是常见的慢性、全身性炎症性自身免疫性疾病之一，全球估计患病率为1%。若不治疗，RA会导致关节破坏和残疾。加纳针对RA的研究极少，对该疾病的严重程度及相关变量了解甚少。本研究旨在描述加纳一家三级医院中RA患者的临床表现，确定疾病严重程度以及与疾病严重程度相关的危险因素。
本横断面研究于2020年9月至2021年8月进行。该研究纳入了来自科姆福·阿诺克耶教学医院骨科的56名连续同意参与的RA患者。RA的诊断基于风湿病学家采用的更新后的2022年美国风湿病学会/欧洲抗风湿病联盟（ACR/EULAR）类风湿关节炎分类标准。使用一份研究问卷收集参与者的人口统计学和临床特征，实验室检查结果取自患者病历。根据类风湿关节炎疾病活动评分（基于28个关节计数的DAS28）评估患者的疾病严重程度，使用改良健康评估问卷评估其功能状况。
参与者的平均年龄为51.25±13.22岁。在所有参与者中，46名是女性，10名是男性（女性与男性比例为4.6∶1）。此外，37.50%的患者有手部关节炎；5.30%患有严重疾病，94.60%病情不严重。大多数（76.80%）患者正在服用甲氨蝶呤药物。最常受累的关节是膝关节（42.90%）、腕关节（32.10%）和肘关节（12.50%）。疾病严重程度与功能状态评分>0.5之间无统计学显著关联（校正比值比：10.60，95%置信区间（0.52 - 217.30）；P = 0.124）。此外，婚姻状况（P = 0.04）、病程（P = 0.04）、家族病史（P = 0.02）和红细胞沉降率（P = 0.03）与疾病严重程度显著相关。
RA在老年人群和女性中更为常见。病程、家族病史和红细胞沉降率与疾病严重程度相关。本研究结果呼吁采取干预措施，确保在高危人群中早期诊断RA，以加强良好的管理实践。
