Department of Rheumatology, Westmead Hospital, Sydney, New South Wales, Australia.
Westmead Clinical School, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.
Intern Med J. 2024 Oct;54(10):1603-1615. doi: 10.1111/imj.16489. Epub 2024 Aug 13.
The objective of this article is to summarise the current knowledge regarding the prevalence of six rheumatological conditions in indigenous Australians - rheumatoid arthritis (RA), osteoarthritis (OA), osteoporosis (OSP), systemic lupus erythematosus (SLE), gout and musculoskeletal (MSK) pain. Online medical literature databases were searched for 'indigenous', 'Aboriginal' and 'Torres Strait Islander', as well as the names of the six conditions. Other included search terms were 'crystal', 'urate', 'arthritis' and 'arthropathy'. No limitations were placed on publication data or language. Forty-five articles examining the prevalence of the six conditions were identified. Based on the published literature, SLE appears to have a higher prevalence, while RA appears to have a lower prevalence in indigenous Australians compared to the non-indigenous community. MSK pain is prevalent, has a significant impact on indigenous people and is perceived as an important area of need. There is a paucity of data regarding these conditions in indigenous Australians. This may be impacted by the uncertainty of case ascertainment by self-report, differences in disease phenotypes and prevalence between the metropolitan compared to the rural or remote indigenous population, and difficulty with access to healthcare. Further studies in conjunction with local indigenous communities are needed to accurately determine the burden of rheumatological disease in the indigenous population. This will assist with resource and workforce planning to deliver culturally appropriate interventions. Strategies for future clinical work and research include the development and dissemination of culturally safe rheumatology resources, rheumatology training of Aboriginal Health Workers and wider integration of rheumatology clinics into community-controlled Aboriginal Health Services.
本文旨在总结目前关于澳大利亚原住民中六种风湿性疾病（类风湿关节炎、骨关节炎、骨质疏松症、系统性红斑狼疮、痛风和肌肉骨骼疼痛）流行情况的知识。在线医学文献数据库中搜索了“原住民”、“土著”和“托雷斯海峡岛民”以及六种疾病的名称。其他包括的搜索词有“晶体”、“尿酸盐”、“关节炎”和“关节病”。未对出版物数据或语言进行限制。共确定了 45 篇研究六种疾病流行情况的文章。根据已发表的文献，与非原住民社区相比，SLE 在原住民中的患病率似乎更高，而 RA 的患病率似乎更低。肌肉骨骼疼痛普遍存在，对原住民有重大影响，被认为是一个重要的需求领域。关于原住民中这些疾病的数据很少。这可能是由于自我报告的病例确定的不确定性、大都市人群与农村或偏远原住民人群之间的疾病表型和流行率差异，以及获得医疗保健的困难所导致的。需要与当地原住民社区合作进行进一步研究，以准确确定风湿性疾病在原住民人群中的负担。这将有助于资源和劳动力规划，以提供文化上适当的干预措施。未来临床工作和研究的策略包括开发和传播文化安全的风湿病资源、对原住民卫生工作者进行风湿病培训以及更广泛地将风湿病诊所纳入社区控制的原住民卫生服务。
