| dc.description.abstract | Background: The prevalence of rheumatic diseases has increased exponentially globally due to increasing urbanization and lifespan with these diseases constituting a major impact on both quality of life and life expectancy. Their diversity in Africa however is largely unknown but their burden is thought to be even higher because of late diagnosis, poor access to care and socio-cultural beliefs.
Similarly, in Uganda, no studies have elaborately studied the diversity of rheumatic diseases and therefore their impact on the quality of life.
Study Objective: To determine the spectrum and health related quality of life associated with rheumatic diseases at Mulago National Referral Hospital and St. Francis Hospital Nsambya rheumatology clinics.
Methods: In this survey that included two tertiary rheumatology clinics at the two urban referral hospitals, consecutive sampling was used to come up with an adequate number of patients with symptoms and signs that fulfill the various rheumatic diseases diagnostic criteria or other standard clinical criteria. Consented follow up and new patients to the clinics ≥ 18 years were enrolled between January 2022 and July 2022. Baseline characteristics, clinical presentation, diagnoses, treatments and co-morbidities were documented. The obtained information was filled on case description forms; assessment of the Health Related Quality of life for all patients was done using the EQ-5D-5L questionnaire. This information was analyzed and described.
Results: A total of 324 participants were enrolled into the study. The participants’ median age was 50 (IQR: 37-60) years with most of them, 123 participants (38%) middle aged, and female 271 (83.6%). Most of the participants had rheumatoid arthritis 104 (32.1%) followed by osteoarthritis 80 (24.7%). The commonest co-morbidity was hypertension 87 (76.3%) while non-steroidal anti-inflammatory drugs were the most prescribed medication in 243 participants (75.2%).
Two hundred eight participants (66.9%) had moderate or severe pain while 149 participants (46%) had a moderate or severe mobility concern. Two hundred thirty four participants (72.1%) had at least a complaint of anxiety or depression. For both the overall health index and overall self-rated status on the visual analogue scale assessment, follow up participants versus new participants had higher scores of 0.649±0.176 versus 0.558±0.188 (p-value of <0.001); 53.6±21% versus 46.3±18.7% (p-value of 0.039) respectively and, participants younger than 51 years versus participants older than 51 years had higher scores of 0.657±0.161 versus 0.618±0.160 (p-value of 0.029); 55.2±21.9% versus 50.0±19.4% (p-value of 0.024) respectively. For the overall self-rated status on the visual analogue scale, skilled workers also had a higher score of 55.1±21.2% versus unemployed participants 44.6±19.5% (p-value of 0.019) while participants with a comorbidity had a lower score of 48.9±19.7% compared to 54.8±21.2% of participants without a comorbidity, (p-value of 0.016).
Conclusions and recommendations:
Rheumatic and musculoskeletal diseases are common among female middle aged patients with rheumatoid arthritis and osteoarthritis being the most prevalent. There is significant decline in the health related quality of life which is mostly impaired in the pain, mobility and anxiety or depression dimensions with however patients followed up in the clinics and those younger than 51 years exhibiting a better quality of life. Improving the quality of life among this population is paramount to lessen the burden of rheumatic diseases. | en_US |
