PREVALENCE OF COMORBIDITIES IN RHEUMATOID ARTHRITIS PATIENTS AT SAINT PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE, ADDIS ABABA, ETHIOPIA

Abstract

ABSTRACT Background: Rheumatoid arthritis is a chronic inflammatory disease that affects the quality of life and, if left untreated, increases morbidity and mortality. Comorbidity is common due to the disease process or secondary to the medication, and in Ethiopia, there is no study that addresses the prevalence of comorbidities in RA and disease characteristics, so this study will fill the knowledge gap, to provide appropriate screening and treatment of comorbidities in RA, and also it will be used as a baseline to conduct a large study. Objective: The study aims to assess the prevalence of comorbidities in rheumatoid arthritis and disease characteristics at Saint Paul Millennium Medical College, from February to July 2022. Methodology: A cross-sectional descriptive study was conducted on 103 rheumatoid arthritis patients who had follow-ups at the rheumatology clinic of Saint Paul Millennium Medical College hospital from February to July. A structured checklist was prepared in English with a translation into Amharic, with components of demographic data, clinical characteristics, and comorbidity. The collected data was entered into a computer using the Statistical Package for Social Sciences version 25.0 for Windows. Means, standard deviations, and percentages were calculated. Results: In our study, females represented 81.6%, with a ratio of 4.4:1, and the mean (SD) age was 45.1 (12.9) years. RF-positive serology was in 73.8% and 99% of the patients were treated for less than 10 years. Screening was conducted for diabetes (76.7%), dyslipidemia (50.5%), HBV (34.9%), and HCV (35.9%). Comorbidity was found in 40.8%. Hypertension (28.2%) and dyslipidemia (22.3%) are the commonest comorbidities, while type 2 diabetes occurs in 10.1%, whereas obesity is 8.7%, hepatitis B virus 5.4%, depression 3.9%, and tuberculosis is 2.9%. A DMARD was used in 79.6% of cases, with 81.7% on a single DMARD. Among these, methotrexate was prescribed in 71.8% of the cases, followed by chloroquine in 22.3%. There was no biologics usage during the study period. Periodontal disease was found in 26.2%, whereas 15.5% of the patients had a positive family history of RA, and smoking was seen in 5.8%. Conclusion: Hypertension is the most common prevalent comorbidity in RA, followed by dyslipidemia and diabetes consecutively, and screening for HCV, HBV, dyslipidemia, and diabetes is insufficient. Most of the patients are on a single DMARD. The impact of this study on future decision-making needs to be verified with multicenter, prospective studies by including other variables. Key words: Comorbidity, Rheumatoid Arthritis, disease characteristics,