A Review of the Prevalence and Unmet Needs in the Management of Rheumatoid Arthritis in Africa and the Middle East
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REVIEW
A Review of the Prevalence and Unmet Needs in the Management of Rheumatoid Arthritis in Africa and the Middle East Hani Almoallim
. Jamal Al Saleh . Humeira Badsha .
Haytham Mohamed Ahmed
. Sara Habjoka . Jeanine A. Menassa .
Ayman El-Garf
Received: September 21, 2020 / Accepted: October 31, 2020 Ó The Author(s) 2020
ABSTRACT Estimates of the global prevalence of rheumatoid arthritis (RA) range from 0.24 to 1%, but vary considerably around the globe. A variation in RA prevalence is also expected across Africa and the Middle East, due to ethnic, climate, and socioeconomic differences. To assess the prevalence of RA in Africa and the Middle East, we searched Medline (via PubMed) and databases of major rheumatology conferences. Seventeen journal articles and 0 abstracts met the Hani Almoallim and Jamal Al Saleh contributed equally to this work. H. Almoallim (&) Faculty of Medicine, Umm-Al-Qura University, Makkah, Saudi Arabia e-mail: [email protected] J. Al Saleh Dubai Hospital, Dubai, United Arab Emirates H. Badsha Dr Humeira Badsha Medical Center, Dubai, United Arab Emirates H. M. Ahmed S. Habjoka Pfizer Biopharmaceutical Group, Emerging Markets, Dubai, United Arab Emirates J. A. Menassa Faculty of Medicine, Lebanese University Hospital, Beirut, Lebanon A. El-Garf Faculty of Medicine, Cairo University, Cairo, Egypt
inclusion criteria. Estimated prevalence ranged from 0.06 to 3.4%. Most studies reported values near or below 0.25%. Consistent with data from other regions, RA was more prevalent among urban than rural populations, and among women than men. The women:men prevalence ratio ranged from 1.3:1 to 12.5:1, which suggests notable differences from the global average of 2:1. Relative increases in prevalence were observed in North Africa and the Middle East (13% since 1990) and Western Sub-Saharan Africa (14%), whereas rates in Eastern, Central, and Southern Sub-Saharan Africa show decreases (4–12%). Low disease awareness, delays to visit rheumatologists, and socioeconomic factors appear to hinder early diagnosis and aggressive treatment. Few countries have developed RA-specific treatment guidelines, and many physicians and patients face limited access to even basic treatments. An improved understanding of the epidemiology and management of RA, and the related socioeconomic consequences is necessary, so that targeted attempts can be made to encourage early diagnosis and treatment.
Keywords: Africa; Arab; Management; Middle East; Prevalence; Rheumatoid arthritis
Rheumatol Ther
Key Summary Points Why carry out this study? While rheumatoid arthritis (RA) affects 0.24–1% of the worldwide population, variations in prevalence can be expected across Africa and the Middle East (AfME) due to ethnic, climate, and socioeconomic differences. In this review, we discuss data on the prevalence of RA in the AfME region published in the last 10 years as well as potential barriers to effective treatment. What was learned from the study? Prevalence ranged from 0.06 to 3.4% across countries in the region, altho
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