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Current Rheumatology Reviews

Editor-in-Chief

ISSN (Print): 1573-3971
ISSN (Online): 1875-6360

Research Article

Insight into the Epidemiology of the Adult-onset Systemic Autoimmune Rheumatic Diseases in Egypt: A Descriptive Study of 8690 Patients

Author(s): Doaa H.S. Attia*, Eman R. Mohamed, Ahmed Y. Ismaeel, Yossra A. Suliman, Nermeen H.A. Moneim and Rasha A. Abdel Noor

Volume 20, Issue 5, 2024

Published on: 16 January, 2024

Page: [522 - 533] Pages: 12

DOI: 10.2174/0115733971277833231226071516

Price: $65

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Abstract

Background/Objective: Although systemic autoimmune rheumatic diseases (SARDs) seem to be ubiquitous, Africa and the Middle East seem to be a remarkable exception with scarcity of data compared with the developed countries. Furthermore, most of the studies addressed a particular disease. This work aimed to shed light on the relative frequency and epidemiology of the different adult-onset SARDs in Egypt.

Methods: This is a retrospective hospital-based study including six university hospitals providing free health care services: Cairo, Alexandria, Tanta, Suez Canal, Beni-Suef and Assiut University Hospitals. All available files for patients attending the outpatient clinics or admitted to the inpatient departments between January 2000 and December 2021 were retrospectively reviewed. Data about the patient’s diagnosis, gender, age at disease onset, year of disease onset and residence were collected.

Results: The study included 8690 patients. Rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Behçet’s disease (BD) and spondyloarthropathies (SPA) represented the main SARDs in Egypt. They mainly affect young patients below the age of 40 years. RA and SLE mainly affect females; males are mainly affected by axial SPA and BD. There is an increasing incidence of SARDs during the study period.

Conclusion: The study revealed the high burden of SARDs in Egypt, helping better allocation of economic resources for the management of diseases of the highest prevalence and those affecting the young reproductive age groups. Increased public and medical staff awareness about SARDs is recommended to help early referral of patients to rheumatologists and, hence, better estimation of their epidemiology.

Keywords: Epidemiology, systemic autoimmune rheumatic diseases, rheumatoid arthritis, systemic lupus erythematosus (SLE), Behçet’s disease (BD), spondyloarthropathies (SPA).

Graphical Abstract
[1]
Fautrel B, Guillemin F. Cost of illness studies in rheumatic diseases. Curr Opin Rheumatol 2002; 14(2): 121-6.
[http://dx.doi.org/10.1097/00002281-200203000-00008] [PMID: 11845016]
[2]
Elliott P, Wartenberg D. Spatial epidemiology: Current approaches and future challenges. Environ Health Perspect 2004; 112(9): 998-1006.
[http://dx.doi.org/10.1289/ehp.6735] [PMID: 15198920]
[3]
Adelowo O, Mody GM, Tikly M, Oyoo O, Slimani S. Rheumatic diseases in Africa. Nat Rev Rheumatol 2021; 17(6): 363-74.
[http://dx.doi.org/10.1038/s41584-021-00603-4] [PMID: 33850309]
[4]
Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT. Rheumatoid arthritis classification criteria: An American College of Rheumatology/European League against Rheumatism collaborative initiative. Arthritis Rheum 2010; 62: 2569-81.
[http://dx.doi.org/10.1002/art.27584] [PMID: 20872595]
[5]
Linden SVD, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum 1984; 27(4): 361-8.
[http://dx.doi.org/10.1002/art.1780270401] [PMID: 6231933]
[6]
Rudwaleit M, van der Heijde D, Landewé R, et al. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): Validation and final selection. Ann Rheum Dis 2009; 68(6): 777-83.
[http://dx.doi.org/10.1136/ard.2009.108233] [PMID: 19297344]
[7]
Rudwaleit M, van der Heijde D, Landewé R, et al. The assessment of spondyloarthritis international society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general. Ann Rheum Dis 2011; 70(1): 25-31.
[http://dx.doi.org/10.1136/ard.2010.133645] [PMID: 21109520]
[8]
Tillett W, Costa L, Jadon D, et al. The classification for Psoriatic ARthritis (CASPAR) criteria-a retrospective feasibility, sensitivity, and specificity study. J Rheumatol 2012; 39(1): 154-6.
[http://dx.doi.org/10.3899/jrheum.110845] [PMID: 22089469]
[9]
Petri M, Orbai AM, Alarcón GS, et al. Derivation and validation of the systemic lupus international collaborating clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum 2012; 64(8): 2677-86.
[http://dx.doi.org/10.1002/art.34473] [PMID: 22553077]
[10]
Vitali C, Bombardieri S, Jonsson R, et al. Classification criteria for Sjogren’s syndrome: A revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis 2002; 61(6): 554-8.
[http://dx.doi.org/10.1136/ard.61.6.554] [PMID: 12006334]
[11]
Miyakis S, Lockshin MD, Atsumi T, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome. J Thromb Haemost 2006; 4: 295-306.
[http://dx.doi.org/10.1111/j.1538-7836.2006.01753.x] [PMID: 16420554]
[12]
van den Hoogen F, Khanna D, Fransen J, et al. 2013 classification criteria for systemic sclerosis: An American college of rheumatology/European league against rheumatism collaborative initiative. Ann Rheum Dis 2013; 72(11): 1747-55.
[http://dx.doi.org/10.1136/annrheumdis-2013-204424] [PMID: 24092682]
[13]
Alarcón-Segovia D, Cardiel MH. Comparison between 3 diagnostic criteria for mixed connective tissue disease. Study of 593 patients. J Rheumatol 1989; 16(3): 328-34.
[PMID: 2724251]
[14]
Bohan A, Peter JB. Polymyositis and dermatomyositis. N Engl J Med 1975; 292(7): 344-7.
[http://dx.doi.org/10.1056/NEJM197502132920706] [PMID: 1090839]
[15]
International Team for the Revision of International Criteria for Behçet’s Disease. Clinical manifestations of Behçet’s disease. The ITR-ICBD report. Clin Exp Rheumatol 2008; 26(Suppl. 50): S1-S18.
[16]
Jennette JC, Falk RJ, Bacon PA, et al. 2012 Revised international chapel hill consensus conference nomenclature of vasculitides. Arthritis Rheum 2013; 65(1): 1-11.
[http://dx.doi.org/10.1002/art.37715] [PMID: 23045170]
[17]
Firestein GS. Etiology and pathogenesis of rheumatoid arthritis. In: Firestein GS, Budd RC, Gabriel SE, McInnes LB, O’Dell JR, Eds. Kelley and Firestein’s Textbook of Rheumatology. Philadelphia, PA: Elsevier 2017; pp. 1059-1108e5.
[http://dx.doi.org/10.1016/B978-0-323-31696-5.00069-3]
[18]
Goma SH, Mahran DG, El-Hakeim EH, et al. Spectrum of rheumatic diseases in Egypt is similar/ different from that in non-Arabic countries. An inpatient comparison. Res Rev Neurosci 2016; 1: 6-14.
[19]
Gaston JSH. Reactive arthritis and undifferentiated spondyloarthritis. In: Firestein GS, Budd RC, Gabriel SE, Mcinnes LB, O’Dell JR, Eds. Kelley & Firestein’s textbook of rheumatology. (10th ed..). Philadelphia: Elsevier 2017; pp. 1520-40.
[http://dx.doi.org/10.1016/B978-0-323-31696-5.00133-9]
[20]
Statistics yearbook. Available from:https://www.capmas.gov.eg/Pages/StaticPages.aspx?page_id=5034 (Accessed March 24, 2022).
[21]
Jean-Claude D, Edmond E, Ignace D, Boubacar O, Baly O, N’zué Marcel K. Inflammatory rheumatic diseases at Cocody university medical center (Abidjan) from March 1998 to March 2000. Joint Bone Spine 2004; 71(6): 598-9.
[http://dx.doi.org/10.1016/j.jbspin.2004.04.011] [PMID: 15589450]
[22]
Ouédraogo DD, Ntsiba H, Zabsonré J, et al. Clinical spectrum of rheumatologic diseases in a department of rheumatology in Ouagadougou (Burkina Faso). Clin Rheumatol 2014; 33(3): 385-9.
[http://dx.doi.org/10.1007/s10067-013-2455-4] [PMID: 24716217]
[23]
Edet M, Otike-Odibi B, Altraide D. Profile of autoimmune connective tissue disorders in the university of port harcourt teaching hospital, port harcourt, Nigeria. Nigerian Health J 2015; 15(2): 39-47.
[24]
Oguntona SA, Edunjobi AS, Olatunde AO. Prevalence of rheumatic diseases in a rheumatology outpatient practice of a tertiary hospital. Int Res J Med Biomed Sci 2016; 1(2): 11-8.
[25]
Sakr BR, Elfishawi MM, ElArousy MH, et al. Rheumatoid arthritis: A single-center Egyptian experience. Immunol Invest 2018; 47(3): 293-302.
[http://dx.doi.org/10.1080/08820139.2018.1425700] [PMID: 29336618]
[26]
El Hadidi KT, Medhat BM, Baki NM, et al. Characteristics of systemic lupus erythematosus in a sample of the Egyptian population: A retrospective cohort of 1109 patients from a single center. Lupus 2018; 27(6): 1030-8.
[http://dx.doi.org/10.1177/0961203317751856] [PMID: 29431056]
[27]
Symmons DPM. Occasional series: Lupus around the world frequency of lupus in people of african origin. Lupus 1995; 4(3): 176-8.
[http://dx.doi.org/10.1177/096120339500400303] [PMID: 7655486]
[28]
Bernatsky S, Lix L, Hanly JG, et al. Surveillance of systemic autoimmune rheumatic diseases using administrative data. Rheumatol Int 2011; 31(4): 549-54.
[http://dx.doi.org/10.1007/s00296-010-1591-2] [PMID: 20665025]
[29]
Zubieta JAA, Sayre EC, Bernatsky S, et al. Adult prevalence of Systemic Autoimmune Rheumatic Diseases (SARDs) in british columbia, Canada. Arthritis Rheum 2011; 63(Suppl. 10): 1846.
[30]
Broten L, Aviña-Zubieta JA, Lacaille D, et al. Systemic autoimmune rheumatic disease prevalence in Canada: Updated analyses across 7 provinces. J Rheumatol 2014; 41(4): 673-9.
[http://dx.doi.org/10.3899/jrheum.130667] [PMID: 24584928]
[31]
Jacobson DL, Gange SJ, Rose NR, Graham NMH. Epidemiology and estimated population burden of selected autoimmune diseases in the United States. Clin Immunol Immunopathol 1997; 84(3): 223-43.
[http://dx.doi.org/10.1006/clin.1997.4412] [PMID: 9281381]
[32]
West SG, Kolfenbach J. Classification and health impact of the rheumatic diseases. In: Kolfenbach J, Ed. Rheumatology Secrets. Elsevier 2021; pp. 1-5.
[33]
Molokhia M, McKeigue P. Risk for rheumatic disease in relation to ethnicity and admixture. Arthritis Res 2000; 2(2): 115-25.
[http://dx.doi.org/10.1186/ar76] [PMID: 11094421]
[34]
Arnett FC, Howard RF, Tan F, et al. Increased prevalence of systemic sclerosis in a native american tribe in oklahoma. Association with an amerindian HLA haplotype. Arthritis Rheum 1996; 39(8): 1362-70.
[http://dx.doi.org/10.1002/art.1780390814] [PMID: 8702445]
[35]
Senna ER, De Barros AL, Silva EO, et al. Prevalence of rheumatic diseases in Brazil: A study using the COPCORD approach. J Rheumatol 2004; 31(3): 594-7.
[PMID: 14994410]
[36]
Granados Y, Cedeño L, Rosillo C, et al. Prevalence of musculoskeletal disorders and rheumatic diseases in an urban community in Monagas State, Venezuela: A COPCORD study. Clin Rheumatol 2015; 34(5): 871-7.
[http://dx.doi.org/10.1007/s10067-014-2689-9] [PMID: 24924602]
[37]
Peláez-Ballestas I, Sanin LH, Moreno-Montoya J, et al. Epidemiology of the rheumatic diseases in Mexico. A study of 5 regions based on the COPCORD methodology. J Rheumatol Suppl 2011; 86(0): 3-8.
[http://dx.doi.org/10.3899/jrheum.100951] [PMID: 21196592]
[38]
Londoño J, Ballestas I, Cuervo F, et al. Prevalence of rheumatic disease in Colombia according to the Colombian Rheumatology Association (COPCORD) strategy. Prevalence study of rheumatic disease in Colombian population older than 18 years. Colomb J Rheumatol 2018; 25(4): 245-56.
[http://dx.doi.org/10.1016/j.rcreue.2018.08.003]
[39]
Minaur N, Sawyers S, Parker J, Darmawan J. Rheumatic disease in an australian aboriginal community in North Queensland, Australia. A WHO-ILAR COPCORD survey. J Rheumatol 2004; 31(5): 965-72.
[PMID: 15124258]
[40]
Söderlin MK, Börjesson O, Kautiainen H, Skogh T, Leirisalo-Repo M. Annual incidence of inflammatory joint diseases in a population based study in southern Sweden. Ann Rheum Dis 2002; 61(10): 911-5.
[http://dx.doi.org/10.1136/ard.61.10.911] [PMID: 12228162]
[41]
Anagnostopoulos I, Zinzaras E, Alexiou I, et al. The prevalence of rheumatic diseases in central Greece: A population survey. BMC Musculoskelet Disord 2010; 11(1): 98.
[http://dx.doi.org/10.1186/1471-2474-11-98] [PMID: 20504294]
[42]
Kononoff A, Arstila L, Pussinen P, et al. Incidence of inflammatory joint diseases in Finland: Results from a population-based epidemiological study. Rheumatol Int 2017; 37(10): 1693-700.
[http://dx.doi.org/10.1007/s00296-017-3779-1] [PMID: 28791449]
[43]
Ghorpade R, Sarmukkadam S, Joshi VL, et al. A staggering burden of pain and rheumatic disorders in India: A national bone & joint decade india community oriented program for control of rheumatic disease survey 2006-2011. Arthritis Rheum 2012; 64(10): S23.
[44]
Galushko EA, Nasonov EL. Prevalence of rheumatic diseases in Russia. Alman Clin Med 2018; 46(1): 32-9.
[http://dx.doi.org/10.18786/2072-0505-2018-46-1-32-39]
[45]
Yu KH, See LC, Kuo CF, Chou IJ, Chou MJ. Prevalence and incidence in patients with autoimmune rheumatic diseases: A nationwide population-based study in Taiwan. Arthritis Care Res 2013; 65(2): 244-50.
[http://dx.doi.org/10.1002/acr.21820] [PMID: 22899470]
[46]
Jokar M, Jokar M. Prevalence of inflammatory rheumatic diseases in a rheumatologic outpatient clinic: Analysis of 12626 cases. Rheumatology Research 2018; 3(1): 21-7.
[http://dx.doi.org/10.22631/rr.2017.69997.1037]
[47]
Vadime E. Introduction: Approaches Old and New to the Silk Roads. The Silk Roads: Highways of Culture and Commerce. Berghahan Books 2000.

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