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Local News |Dubai |
Staff Reporter | Friday, February 1, 2008
New study shows that patients in the UAE
experience one-year delay in diagnosis of Rheumatoid Arthritis
(Dubai Health & News)
In a recent study published in the
Annals of Rheumatic Diseases, a leading European journal, as well as
Clinical Rheumatology, doctors from the Dubai Bone & Joint Center (DBAJ)
showed that patients in the UAE had a lag time of nearly one year in
detection of Rheumatoid Arthritis (RA) and another 9 months before they
were started on the correct treatment.
"There are many reasons for rheumatoid arthritis delay in diagnosis
in the UAE, and all of them need to be addressed to deliver better
quality of life for sufferers in the Emirates," stated Dr. Humeira
Badsha, Specialist Rheumatologist at DBAJ and lead author of the study.
"A key factor is an insufficient numbers of rheumatologists
practicing in the UAE. The World Health Organization recommends 1
rheumatologist for every 100,000 members of the population. Here in the
UAE, there is a definite shortage of trained rheumatologists."
The report also discovered that UAE-based patients suffering with the
ailment had very active disease levels. Disease activity is measured by
DAS28 scores, which are a composite, validated rheumatoid arthritis
scoring system including a record of tender and swollen joints on a 28
joint count, along with Erythrocyte Sedimentation Rate (ESR) and patient
global activity testing. A score of less than 3.2 is considered low
disease activity. In the UAE, patients had DAS28 scores of 5.2, compared
to 3.2 in the USA, and 3.0 in the Netherlands. The study also found that
only 50% of patients were taking medications called disease modifying
drugs, whereas these numbers in western populations are close to 90%.
These drugs are essential to prevent joint damage.
There are typically seven common symptoms of Rheumatoid Arthritis. They
usually include pain in more than one joint, often affecting the
fingers, wrist, elbows, toes, knees, shoulders and ankles.
Swelling of joints may also occur; this generally makes joints feel like
small balloons filled with water. Patients may also suffer from joint
stiffness which is normally at its worst first thing in the morning or
after extended periods of inactivity. Characteristically, the disease
will affect both sides of the body equally and nodules or lumps may
develop under the skin in different areas. Blood tests for Rheumatoid
Arthritis are positive in 75% of patients and X-rays can show
"erosions" or joint damage only in later stages of the
disease. Individuals will normally have at least four of these symptoms
in order to be diagnosed with Rheumatoid Arthritis.
"Several steps can be urgently taken to improve the care of
rheumatoid arthritis in the UAE,' said Dr. Badsha, "including
increasing patient awareness of the necessity to seek early specialist
opinion and obtain the right treatment."
The study was conducted on 100 patients with an average age of 42.2 (+/-
12.3 years). The UAE's diverse background was evident when studying the
racial background of each patient. Of those examined, 38% were of Arab
descent, 36% were of Indian descent and 26% percent were of Caucasian or
other nationality. With the wide range of ethnic backgrounds taken into
consideration, the study showed that there are no racial differences in
disease characteristics with a majority of patients having very active
disease, delayed diagnosis and not appropriately treated with disease
modifying drugs.
As Rheumatoid Arthritis is a systematic disease which affects the entire
body, early diagnosis can provide the steps required to keep the ailment
under control, aside from the joints. Early treatment can prevent joint
damage and deformity. With early identification, sufferers can learn the
steps to manage the disease through medication, rest, exercise, and a
better understanding of how to protect their joints.
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Dr. Humeira Badsha, Specialist
Rheumatologist, Dubai Bone & Joint Center (DBAJ) in Dubai.
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