Comorbidities in Black South Africans with Rheumatoid Arthritis

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dc.contributor.authorLala, Vikash Goolab
dc.date.accessioned2018-09-07T09:43:36Z
dc.date.available2018-09-07T09:43:36Z
dc.date.issued2018
dc.descriptionA research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg in partial fulfilment of the degree of Master of Medicine in Internal Medicine. Johannesburg, 2018.en_ZA
dc.description.abstractIntroduction: Comorbidities occur commonly in rheumatoid arthritis(RA) but little is known about their prevalence and spectrum in South Africans. Objectives: To determine the prevalence and associated risk factors of comorbidities in black South Africans with RA. Methods: A retrospective record review of black RA patients at a tertiary rheumatology service. The cumulative comorbidity score was assessed using the Charlson comorbidity score. Results: Of the 500 patients studied, the mean(SD) age and disease duration was 60.0(11.1) and 10.7(5.0) years, respectively. Most patients (50.5%) had severe disability (functional class 3-4) at diagnosis with 98% of patients having had ≥1 comorbidities. The median number of comorbidities was 3.0(IQR 2.0-4.0). Comorbidities were a function of age, follow up duration and disability (p=<0.001). The table below shows the common comorbidities. Prevalence (%) Prevalence (%) Anaemia 391(78.2) Tuberculosis 53(10.6) Hypertension 350(70.0) HIV (n=204) 44(9.3) Peptic ulcer disease (PUD)(n=114) 73(64.0) Congestive heart failure 33(6.6) Hypercholesterolemia (n=466) 221(47.4) Cerebrovascular disease 14(2.8) Osteoporosis (n=132) 62(47.0) Malignancy 9(1.8) Diabetes mellitus 77(15.4) Ischaemic heart disease 3(0.6) Serious infections 56(11.2) Serious infections occurred more commonly in those with osteoporosis (OR-4.32), vasculitis (OR-4.0), anaemia (OR-3.62) and HIV (OR-2.32). Patients with the following comorbidities were more likely to have deceased during follow up: CCF (OR-5.44), serious infections (OR-4.58), interstitial lung disease (OR-3.91), arthroplasty (OR-2.46), TB (OR-2.22) and PUD (OR-1.54). Conclusion: Despite the high prevalence of cardiac risk factors in this population, the prevalence of ischaemic heart disease remains low. Osteoporosis is commonly found in RA patients undergoing DEXA scans.en_ZA
dc.description.librarianLG2018en_ZA
dc.identifier.urihttps://hdl.handle.net/10539/25588
dc.language.isoenen_ZA
dc.subject.meshComorbidities
dc.subject.meshArthritis, Rheumatoid
dc.titleComorbidities in Black South Africans with Rheumatoid Arthritisen_ZA
dc.typeThesisen_ZA
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