Low Incidence of Rheumatoid Factor and Autoantibodies in Nigerian Patients with Rheumatoid Arthritis

Greenwood, Brian; Herrick, Erina M.

doi:10.1136/bmj.1.5688.71

Cited by 15 publications

(4 citation statements)

References 11 publications

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“…7 in Uganda by Kanyerezi (11), the 1 :2.3 in Zimbabwe by Lutalo (21) and the 1:3.7 found in Durban, South Africa by Mody and Meyers (22), all of which are comparable with the 1: 3 found in most caucacian studies (2). The female preponderance widely reported in RA is thus accompanied by wide regional variation and indeed, in a study in Nigeria, no significant difference between the number of males and females with RA was recorded (24). A community based study is however necessary in order to come up with a more reliable figure for the local population.…”

Section: Discussionmentioning

confidence: 96%

Socio-demographic and clinical aspects of rheumatoid arthritis

Owino¹,

Oyoo²,

Otieno³

2010

E Af Med Jrnl

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Objective: To determine the socio-demographic profiles and some clinical aspects of patients with rheumatoid arthritis (RA). Design: Prospective, cross-sectional study. Setting: Ambulatory outpatient clinics of Kenyatta National Hospital (KNH), a public national and referral hospital. Subjects: Out of 180 patients interviewed and examined, 60 met American College of Rheumatology (ACR) diagnostic criteria of RA. Results: Of the 60 patients recruited 52 (87%) were females with male: female ratio of 1: 6.5. The mean age of patients was 41.38(± 16.8) years. There were two peaks of age of occurrence, 20-29 and 40-49 years. In 75% of the study patients, one or more of metacarpophalangeal joints of the hand were involved in the disease. Other frequently involved sites were-wrists, elbows, knees, ankles and glenohumeral joints of shoulders in a symmetrical manner. Serum rheumatoid factor was positive in 78.9% while rheumatoid nodules were present in 13.3% of the study patients. A large majority of patients (88%) had active disease with 18% having mild disease, 38% moderate activity and 32% having severe disease. Only 12% of patients had disease in remission. Forty six point seven per cent (46.7%) of the study patients were on at least one Disease Modifying anti Rheumatic Drugs (DMARD) from a selection of methotrexate, sulphasalazine, hydroxychloroquine and leflunamide. The most frequent drug combination was methotrexate plus prednisolone at 30% of the study population; while 66.7% were on oral prednisolone with 25% of the study patients taking only Non-Steroidal anti Inflammatory Drugs (NSAIDS). Conclusion: A large majority of ambulatory patients with RA had active disease. Most of' them were sub-optimally treated, especially the use of DMARDS. About two thirds were on oral steroids. Sub-optimal therapy in relatively young patients, peak 20-29 and 40-49 years is likely to impact negatively on their disease control and quality of life.

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Section: Discussionmentioning

confidence: 96%

Socio-demographic and clinical aspects of rheumatoid arthritis

Owino¹,

Oyoo²,

Otieno³

2010

E Af Med Jrnl

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“…As such they pose a number of questions concerning diseases known to be associated with particular HLA alleles in Caucasoids. Greenwood et al (1969Greenwood et al ( , 1970 have described mild rheumatoid arthritis (RA) in Nigerian patients satisfying ARA criteria, even though HLA-Dw4 and DR4 are either absent from this population or present at very low frequency. The particularly mild features of RA in Nigerians may be due to the absence of Dw4 and DR4 as it has been shown that these antigens are most highly associated with the presence of erosions (Young et al 1984).…”

Section: Discussionmentioning

confidence: 99%

HLA polymorphisms in Nigerians

et al. 1985

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The HLA class I and class 11 phenotypes of a panel of 114 unrelated Nigerians have been determined. The panel was tested for all the known class I antigens and comparisons of the HLA-A and -B frequencies with those of other African Negroid populations revealed some differences. Only limited comparisons could be made for the HLA-DR and -D frequencies as these are not available for any well-defined African Negroid population. The data concerning the class I1 antigens of this panel are the most interesting. Half of the DRwll-positive panel members are DQw3 negative and DQwl positive. in addition, there is dissociation of some HLA-D and -DR specificities, a number of panel members are positive for an HLA-D specificity and are negative for the corresponding HLA-DR specificity. Our results show the value of population studies in the investigation of the relationship between the different HLA class 11 antigens.

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“…Anaya et al reported no significant differences between African Colombians and Mestizo patients in terms of presence of RF which was positive in 14 (78%) African Colombian and 48 (86%) mestizo [13]. The literature underlines a high frequency of RF in healthy African subjects [69]. In Cameroon, Singwe-Ngandeu et al found IgM RF in 16% of healthy subjects [18].…”

Section: Rheumatoid Factorsmentioning

confidence: 98%

Challenges of Rheumatoid Arthritis Management in Sub-Saharan Africa in the 21st Century

Kolou¹

2023

OJRA

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In recent decades, several advances have been made in the management of rheumatoid arthritis (RA) both in the diagnostic field and in the therapeutic field. Unfortunately, RA remains poorly studied in black Africa. Epidemiological data are rare and controversial. The estimated prevalence of RA in Africa is about 0% -2.54%. Risk factors associated with RA must be studied by taking into account special features of black Africa such as the low tobacco consumption in certain regions, the tropical climate and the high frequency of endemic parasitic and viral infections. The initially supposed mildness of RA in black Africa is increasingly challenged. The diagnosis is often made too late because of the scarcity of rheumatologists and ignorance. Diagnostic tools are limited to the clinical data, the erythrocyte sedimentation rate and radiographs as the other tools are poorly available. In addition, there are misconceptions in African communities, responsible for loss of sight during follow-up and treatment discontinuations. This is exacerbated by the shortage of disease-modifying anti-rheumatic drugs (DMARDs) and the inability to afford them. Furthermore, biological agents are very difficult to access. Further studies are essential to better understand the characteristics of RA in black Africa. Thus, collaborations between African and Western research teams seem very important. In order to make available the DMARDs especially biological agents, pharmaceutical companies can contribute through research partnerships. Moreover, governments should provide a better place for chronic inflammatory diseases in the programs against non-communicable diseases. Finally, training must also be promoted to increase the number of specialists and the level of knowledge of other health workers.

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Low Incidence of Rheumatoid Factor and Autoantibodies in Nigerian Patients with Rheumatoid Arthritis

Cited by 15 publications

References 11 publications

Socio-demographic and clinical aspects of rheumatoid arthritis

Socio-demographic and clinical aspects of rheumatoid arthritis

HLA polymorphisms in Nigerians

Challenges of Rheumatoid Arthritis Management in Sub-Saharan Africa in the 21st Century

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