Epidemiology of rheumatic and musculoskeletal diseases in a Nigerian peri-urban community: results of a cross-sectional survey using the COPCORD stage 1 model

Meeting report: The Systemic Lupus International Collaborating Clinics (SLICC) World Lupus Seminar on Africa

The Systemic Lupus International Collaborating Clinics (SLICC) is an international research group dedicated to promoting collaboration among scientific investigators in the study of systemic lupus erythematosus (SLE). Currently, most SLICC members are based in North America and Europe, with limited representation from other regions. SLICC recognises the importance of expanding its global collaborations and representation to ensure that its research accurately reflects the global burden of SLE and provides equal benefit to all patients with SLE worldwide. Given that SLICC currently lacks representation from the African continent, an opportunity was identified to convene a meeting bringing together lupus physicians with experience providing clinical care and conducting lupus research in Africa, along with members of the SLICC group. The purpose of the meeting was to share information regarding SLE in Africa, to discuss recent innovations and current challenges in the region and to explore future collaborations between SLICC members and colleagues in Africa in the areas of SLE clinical care, research and education. This meeting report highlights information presented during the seminar as well as a discussion of next steps moving forward.

Randomized controlled trials of digital health interventions for rheumatic disease management: a systematic review

Objective

To evaluate the adoption, effectiveness and cost-effectiveness of digital health interventions for rheumatic disease management.

Methods

Between 25 May 2024 and 2 June 2024, we systematically searched PubMed®, Scopus, ClinicalTrials.gov, the Global Observatory for eHealth and the World Bank Open Knowledge Repository for randomized controlled trials (RCTs) evaluating digital health interventions for rheumatic disease management. We included studies published between 2000 and 2024 that reported on adoption rates and efficacy. Two reviewers independently screened the studies, extracted data and categorized the digital interventions according to the World Health Organization's classification of digital health interventions.

Findings

Of the 455 unique records identified, 21 RCTs met the inclusion criteria. Most digital health interventions (15 studies) focused on individual-centric interventions, such as targeted communication, personal health tracking, educational tools and wearable devices. Studies in high-income countries implemented advanced, integrated digital interventions combining individual-focused approaches with health worker interventions and data services using telemedicine platforms and decision support systems. In contrast, studies in low- and middle-income countries adapted accessible technologies such as mobile messaging and telephone-based education. Many telehealth, wearable technologies and educational interventions significantly improved disease control, patient adherence, knowledge and self-efficacy. Of the five studies assessing cost-effectiveness, all found digital interventions to be cost-effective.

Conclusion

Digital health interventions show promise for managing rheumatic diseases. Tailoring these interventions to local infrastructure and emphasizing patient engagement are crucial for successful adoption. Future research should focus on standardizing evaluation methods, addressing digital divides and enhancing provider support and data services.

Prevalence and predictors of arthritis among adults in a rural set-up in Kenya: a cross-sectional study

Introduction

arthritis is a significant public health problem affecting many people globally. Exposure to various risk factors puts individuals at risk of developing arthritis. Therefore, this study aimed to assess the prevalence and predictors of arthritis among residents of a rural set-up in Nyamira County, Kenya.

Methods

a community-based cross-sectional study design was employed. Simple random sampling was utilized to select households from a household list. All the residents of the sampled household above 40 years were included. Descriptive analysis was done to describe the study population. Bivariate and multivariate analysis was also done to identify statistically significant arthritis-related variables.

Results

the prevalence of arthritis was 44.6%. Previous joint injury/infection [AOR=2.74; 95%CI=1.59-4.77; p<0.001], being unemployed [AOR=2.77; 95%CI=1.50-5.21; p=0.001], age above 51 years, and hypertension [AOR=1.90; 95%CI=1.03-3.53, p=0.040] were associated with an increased risk of arthritis. Conversely, being male [AOR=0.42; 95% CI=0.22-0.75; p=0.005], standing for > 2 hours [AOR=0.48; 95%CI=0.29-0.81; p=0.006], and constant shifting from sit to stand positions [AOR=0.45; 95% CI=0.26-0.76; p=0.003] were associated with a lower risk of arthritis. Most participants (75%) had an arthritis knowledge score of more than 66%.

Conclusion

the study found a high prevalence of arthritis in the community. Arthritis was strongly associated with various risk factors under study. Therefore, there is a need to take preventive measures for modifiable factors to enhance a reduced prevalence of arthritis.

Rheumatoid arthritis knowledge gap and intervention in Nigeria study

INTRODUCTION

Family physicians are often the first healthcare providers to encounter patients with rheumatoid arthritis (RA) in Nigeria, given the paucity of rheumatology services nationwide. This study aimed to assess and address the knowledge gap regarding RA among family physicians in Nigeria.

METHODS

A cross-sectional survey involving 609 family physicians from all six geopolitical zones of Nigeria was conducted in October 2022. Pre-intervention questionnaires were administered to assess the participants' knowledge of RA. An investigator-led PowerPoint presentation on RA was then delivered as an intervention, followed by the same participants completing post-intervention questionnaires to evaluate knowledge improvement. Data were analyzed using the Statistical Package for Social Science, version 25.

RESULTS

The mean age of participants was 42 ± 15 years, predominantly male (63.9%). The median pre-intervention knowledge score was 3.2 (IQR: 2.0-4.5), with 77.0% scoring <5. After the intervention, the median score significantly improved to 7.1 (IQR: 4.3-8.6) (p = .001), with 62.6% scoring >7. Significant improvements were observed in several knowledge areas where gaps existed pre-intervention, including the understanding that NSAIDs are not the mainstay of management (p < .001), the effectiveness of glucosamine and chondroitin sulfate (p < .001), confidence in diagnosing RA (p = .016), the recognition of joint deformities as a characteristic feature (p < .001), and the understanding that rheumatoid factor is not definitive for diagnosis (p < .001).

CONCLUSION

This study highlights the importance of interventions in closing the knowledge gap about RA diagnosis and management. We recommend the implementation of a comprehensive approach to rheumatology education and services by policymakers.