Main Article Content

Prevalence of functional disability in patients with rheumatoid arthritis attending the rheumatoid outpatient clinic at Kenyatta National Hospital


B.O. Odundo
E.N. Ogola
G.O. Oyoo
E.K. Genga

Abstract

Background: Rheumatoid Arthritis (RA) causes serious joint erosion,  deformity and severe functional disability if not diagnosed early and followed by a timely initiation of Disease Modifying Anti- Rheumatic Drugs (DMARDs). Studies have shown that functional disability is a major determinant on the patients’ quality of life and it is a strong predictor of morbidity, work disability and mortality. Functional disability is measured by patient-oriented tools such as the Health Questionnaire Disability Index (HAQDI) which is the gold standard tool.

Objective: This study aimed to determine the prevalence of RA functional disability and its association with disease activity, socio-demographic and clinical characteristics in patients with rheumatoid arthritis on follow up at the Rheumatology Outpatient Clinic in Kenyatta National Hospital (KNH).

Design: This was a descriptive crosssectional hospital-based study.


Setting: Rheumatology Outpatient Clinic (ROPC) at the Kenyatta National Hospital (KNH); the largest public national and referral hospital in Kenya.

Subjects: One hundred and six patients who fulfi lled the 2010 American College of Rheumatology and the European League Against Rheumatism (ACREULAR) criteria.


Results: There were 102(96.2%) females and 4(3.8%) males recruited into the study with a female to male ratio of 10:1. The prevalence of functional disability was 72.6% with a mean HAQ-DI of 0.41±0.38 which is interpreted as mild disability. Active disease was present in 90.6% of the patients with a median CDAI of 11(IQ range 6.5-22) and mean CDAI score of 15.95±13.08 which represents moderate disease activity and only 9.4% were in remission. The average duration of disease was 5.1 years.  Functional disability was signifi cantly correlated with disease duration and treatment duration.


Conclusion: The study demonstrated a high prevalence of functional disability and a higher disease activity of among RA patients in our setting despite being on DMARDs. There was a signifi cant correlation between functional disability and disease duration. However, there were no  correlations between functional disability and any of the sociodemographic study variables; age, sex, marital status, employment, education and smoking history.


Journal Identifiers


eISSN:
print ISSN: 2307-2482