Silman A J, Ollier W, Holligan S, Birrell F, Adebajo A, Asuzu M C, Thomson W, Pepper L
Arthritis and Rheumatism Council Epidemiology Research Unit, University of Manchester, UK.
J Rheumatol. 1993 Apr;20(4):618-22.
A 2-stage population screening survey of 2,000 inhabitants of 2 rural townships in southern Nigeria was undertaken. No case of rheumatoid arthritis (RA) was discovered in those responding, although 3 cases of inflammatory polyarthritis were found. One of these individuals satisfied the modification of the American College of Rheumatology classification tree criteria that allows for missing radiographic data. Simultaneous monitoring, during a 4-month period, of the local health clinic serving the townships also failed to reveal a case of RA. Three (5.5%) of 55 individuals tested were positive for rheumatoid factor, a rate lower than in previous surveys of rural West African populations. Further immunogenetic investigation of that subsample from this population, using HLA oligonucleotide typing, suggested that HLA-DR4 was rare (1/55). Further, although HLA-DR1 was present in 7 (13%), 6 had the DRB1*0102 variant seen in black populations and not thought to be associated with RA. Our study confirmed the findings of others that rural African groups have extremely low rates of RA. In addition HLA genes containing the RA associated "shared epitope" are also relatively infrequent and might explain this reduction in RA prevalence.
在尼日利亚南部的两个乡村小镇对2000名居民进行了两阶段的人群筛查调查。在回应调查的人群中未发现类风湿性关节炎（RA）病例，不过发现了3例炎症性多关节炎病例。其中1人符合美国风湿病学会分类标准的修订版，该修订版允许缺少放射学数据。在为期4个月的时间里，对为这些乡镇服务的当地健康诊所进行同步监测，也未发现RA病例。在接受检测的55人中，有3人（5.5%）类风湿因子呈阳性，这一比例低于此前对西非农村人群的调查结果。对该人群的那个子样本进一步进行免疫遗传学研究，采用HLA寡核苷酸分型法，结果显示HLA - DR4很罕见（1/55）。此外，尽管有7人（13%）存在HLA - DR1，但其中6人具有在黑人人群中发现的DRB1*0102变异体，且认为该变异体与RA无关。我们的研究证实了其他人的研究结果，即非洲农村人群的RA发病率极低。此外，含有与RA相关的“共享表位”的HLA基因也相对少见，这可能解释了RA患病率的降低。
