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THU0358 The Ability of the Health System to Identify the Burden of Spondyloarthritis in Two Regions of Serbia: A Eular Survey
  1. M.I. Zlatkovic-Svenda1,
  2. R.M. Stojanovic1,
  3. S.B. Sipetic-Grujicic2,
  4. M.M. Radak-Perovic1,
  5. N.S. Damjanov1,
  6. F. Guillemin3
  1. 1Institute of Rheumatology
  2. 2Institute of Epidemiology, University of Belgrade School of Medicine, Belgrade, Serbia
  3. 3INSERM – Cic-Ec, Department of Clinical Epidemiology and Evaluation- University Hospital, and Université de Lorraine, EA 4360 APEMAC, Nancy, France

Abstract

Objectives To determine spondyloarthritis (SpA) prevalence in two different regions of Serbia, as part of the European League Against Rheumatism (EULAR) prevalence survey; to assess the ability of the health system to identify and treat patients with SpA.

Methods Survey comprised a two-stage approach with a sample of urban population in 2 areas: Belgrade, located in the north and Cacak, Uzice and Krusevac in the south, covering 36.5% of the total Serbian population. In a detection phase, every 100-th telephone number was contacted to answer a previously validated screening telephone questionnaire. Confirmation of cases was by contact with the patient's rheumatologist or rheumatological examination. Prevalence results were standardized for age and sex according to Serbian population (national census 2002). Confirmed SpA cases were asked two more questions: “How long had you had symptoms before you were given the diagnosis of SpA” and “How had you been treated for that period of time”.

Results 6213 people were contacted; 63.6% answered the survey; 66 were examined. A total of 16 SpA cases were identified (5 newly diagnosed). The standardized SpA prevalence for the north was 0.28% (95% confidence interval [95% CI] 0.08;0.48); 0.31 (95% CI 0.00;0.65) for men and 0.25% (95% CI 0.01;0.49) for women; for the south 0.42% (0.02;0.82); 0.41 (0.02;0.81) for men and 0.43% (0.04;0.82) for women. Mean (SD) time (months) to SpA diagnosis was 23.6 (24.9) for the north and 13.6 (11.3) for the south; 19.2 (20.2) for Serbia. Before they were given the SpA diagnosis, all patients were treated with NSAIDS, but mostly “on demand” (56.2%), some of them with physical therapy (43.7%) and benzodiazepins (18.7%).

Conclusions SpA prevalence in Serbia does not differ much between southern and northern part of the country as well as between women and men. Diagnostic delay for SpA is 19 months and most of the patients were inadequately treated for that period of time. One third of the revealed SpA cases were not diagnosed previously.

Disclosure of Interest None declared

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