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      Prevalence of rheumatoid arthritis among hospital workers in the north of Jordan: Preliminary report of a hospital-based cohort study

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          Abstract

          Background

          Rheumatoid arthritis (RA) is the most common autoimmune inflammatory arthritis in adults. Prevalence estimates of rheumatoid arthritis vary in the world. Occupational factors and geographical location might contribute to a higher risk of developing the disease, however the exact etiology remains unknown.

          The aim of our study was to estimate the prevalence of RA among hospital workers in the North of Jordan and to compare this prevalence with that in the general population. In addition to describing the characteristics of RA patients.

          Methods

          The study was performed in two stages; during the first stage a specially designed questionnaire was conducted by trained residents with 2569 hospital workers from 6 government hospitals to identify individuals with RA. Suspected individuals of having RA identified in stage one were invited and examined further by two rheumatologists for confirmation of the diagnosis.

          Results

          A total of 2569 employees were interviewed; among them 1240 (48.5%) were males and 1318 (51.5%) were females. The mean (SD) age was 34±(8.4) years. In the second stage the diagnosis of RA according to ACR criteria 1987 was confirmed in 8 individuals (2 males and 6 females). Male: Female (M: F) ratio was 1:3 with mean (SD) age 43.38 (7.52) years. The estimated prevalence of RA among hospital workers in the North of Jordan was 8/2569 = 0.00311, 31.1:10.000, 0.31%, (95% confidence interval, 9.6–52.7:10.000).

          Conclusion

          The prevalence of RA among hospital workers in the North of Jordan is 0.31%, similar to that of other parts of Jordan and neighboring regions.

          Highlights

          • •

            Rheumatoid arthritis is a chronic disabling disease.

          • •

            Data regarding RA in Jordan is very limited. We conducted this study to shed light on how widespread RA.

          • •

            Our study showed similar prevalence of RA in surrounding regions, suggesting influence of environmental and occupational factors.

          • •

            We hope this may help advance patient care and management.

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          Most cited references17

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          The american rheumatism association 1987 revised criteria for the classification of rheumatoid arthritis

          Frank Arnett, Steven M Edworthy, Daniel A. Bloch … (1988)
          The revised criteria for the classification of rheumatoid arthritis (RA) were formulated from a computerized analysis of 262 contemporary, consecutively studied patients with RA and 262 control subjects with rheumatic diseases other than RA (non-RA). The new criteria are as follows: 1) morning stiffness in and around joints lasting at least 1 hour before maximal improvement; 2) soft tissue swelling (arthritis) of 3 or more joint areas observed by a physician; 3) swelling (arthritis) of the proximal interphalangeal, metacarpophalangeal, or wrist joints; 4) symmetric swelling (arthritis); 5) rheumatoid nodules; 6) the presence of rheumatoid factor; and 7) radiographic erosions and/or periarticular osteopenia in hand and/or wrist joints. Criteria 1 through 4 must have been present for at least 6 weeks. Rheumatoid arthritis is defined by the presence of 4 or more criteria, and no further qualifications (classic, definite, or probable) or list of exclusions are required. In addition, a "classification tree" schema is presented which performs equally as well as the traditional (4 of 7) format. The new criteria demonstrated 91-94% sensitivity and 89% specificity for RA when compared with non-RA rheumatic disease control subjects.
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            STROCSS 2019 Guideline: Strengthening the reporting of cohort studies in surgery

            Riaz Agha, Ali Abdall-Razak, Eleanor Crossley … (2019)
            The STROCSS guideline was developed in 2017 to improve the reporting quality of observational studies in surgery. Building on its impact and usefulness, we sought to update the guidelines two years after its publication.
            Article 0 comments Cited 705 times – based on 0 reviews     Review now
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              Environmental risk factors differ between rheumatoid arthritis with and without auto-antibodies against cyclic citrullinated peptides

              Mette Pedersen, Soren Jacobsen, Mette Klarlund … (2006)
              The aim of this study was to evaluate new and previously hypothesised non-genetic risk factors for serologic subtypes of rheumatoid arthritis (RA) defined by the presence or absence of auto-antibodies to cyclic citrullinated peptides (CCP). In a national case-control study, we included 515 patients recently diagnosed with RA according to the American College of Rheumatology 1987 classification criteria and 769 gender- and age-matched population controls. Telephone interviews provided information about non-genetic exposures, and serum samples for patients were tested for anti-CCP-antibodies. Associations between exposure variables and risk of anti-CCP-positive and anti-CCP-negative RA were evaluated using logistic regression. A series of RA subtype-specific risk factors were identified. Tobacco smoking (odds ratio [OR] = 1.65; 95% confidence interval: 1.03–2.64, for >20 versus 0 pack-years) was selectively associated with risk of anti-CCP-positive RA, whereas alcohol consumption exhibited an inverse dose-response association with this RA subtype (OR = 1.98, 1.22–3.19, for 0 versus >0–5 drinks per week). Furthermore, coffee consumption (OR = 2.18; 1.07–4.42, for >10 versus 0 cups per day), ever use of oral contraceptives (OR = 1.65; 1.06–2.57) and having a first-degree relative with schizophrenia (OR = 4.18; 1.54–11.3) appeared more strongly associated with risk of anti-CCP-positive RA. Obesity was selectively associated with risk of anti-CCP-negative RA, with obese individuals being at more than 3-fold increased risk of this subtype compared with normal-weight individuals (OR = 3.45; 1.73–6.87). Age at menarche was the only examined factor that was significantly associated with both serologic subtypes of RA (p-trends = 0.01); women with menarche at age ≥ 15 years had about twice the risk of either RA subtype compared with women with menarche at age ≤ 12 years. Major differences in risk factor profiles suggest distinct etiologies for anti-CCP-positive and anti-CCP-negative RA.
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                Author and article information

                Contributors
                Khaldoon M. Alawneh
                Journal
                Journal ID (nlm-ta): Ann Med Surg (Lond)
                Journal ID (iso-abbrev): Ann Med Surg (Lond)
                Title: Annals of Medicine and Surgery
                Publisher: Elsevier
                ISSN (Electronic): 2049-0801
                Publication date PMC-release: 25 November 2020
                Publication date Collection: December 2020
                Publication date (Electronic): 25 November 2020
                Volume: 60
                Pages: 579-582
                Affiliations
                [a ]King Abdullah University Hospital, Department of Medicine, Jordan University of Science and Technology, Irbid, Jordan
                [b ]Private Rheumatology Clinic, Amman, Jordan
                [c ]Department of Medicine, University of Missouri- Kansas City, Kansas City, MO, USA
                [d ]Department of Mathematics and Statistics, Jordan University of Science and Technology, Irbid, Jordan
                Author notes
                [∗ ]Corresponding author. kalawneh@ 123456just.edu.jo
                Article
                Publisher Item ID: S2049-0801(20)30470-2
                DOI: 10.1016/j.amsu.2020.11.043
                PMC ID: 7708690
                SO-VID: 4cbf4c9c-64d2-4671-bff0-85068e514384
                Copyright © © 2020 The Author(s)
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 27 October 2020
                Date revision received : 12 November 2020
                Date accepted : 12 November 2020
                Categories
                Subject: Cohort Study

                Keywords: rheumatoid arthritis,jordan,prevalence
                Data availability:
                Keywords: rheumatoid arthritis, jordan, prevalence

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