Objectives to estimate the rheumatoid arthritis (RA) prevalence in two urban regions of Serbia, covering the northern and the southern part, under the European League Against Rheumatism (EULAR) prevalence survey; to assess the ability of the health system to recognize and treat patients with RA.
Methods The survey was conducted in four Serbian towns: Belgrade in the north and three towns in the south: Cacak (Moravicki region), Uzice (Zlatiborski region) and Krusevac (Rasinski region), covering 36.5% of the total Serbian population with more than 99% Caucasians, mostly orthodox Serbs (83%), <4% Hungarians, Roms and Bosnians and a minority of other nationalities. The first-detection phase of the study comprised previously translated and validated telephone Questionnaire usage with 33 items covering signs, symptoms, self-reported diagnosis and classification criteria for RA (ACR 1987) (1). Diagnoses were confirmed by rheumatologists in a second-confirmation phase. Prevalence results were standardized for age and sex with regard to Serbian population (national census 2002). Confirmed RA cases were asked two more questions: “How long had you had symptoms before you were given the diagnosis of RA” and “How had you been treated for that period of time”.
Results 6213 people were contacted and 63.6% answered the survey; joint pain was reported by 1,799 persons, and joint pain accompanied with joint swelling by 606 persons. A total of 23 RA cases were identified; 2 newly diagnosed. The standardized RA prevalence estimates were 0.30% (95% confidence interval [95% CI] 0.09;0.51) for the north, e.g. 0.09 (95% CI 0.08;0.26) for men and 0.49% (95% CI 0.19;0.79) for women. RA prevalence estimates were 0.42% (0.12;0.72) for the south; 0.28 (0.00;0.56) for men and 0.55% (0.09;1.00) for women, with the female to male ratio 5,5:1 in the north and 2:1 in the south. Time period from the first symptoms occurence to the RA diagnosis was 17.7 (13.2) months for the northern part and 25.0 (16.9) for the southern; 20.6 (14.9) for Serbia; in that period patients were mostly treated with NSAIDS (82%) and physical therapy (30%); short-lasting corticosteroids were given to 13%, peroral corticosteroids to 4% and no patients were treated with DMARDS.
Conclusions RA prevalence in the southern and northern part of Serbia is in line (0.42% [95% CI 0.12;0.72]) vs 0.30% [95% CI 0.09;0.51]), being more frequently presented in females as compared to males (five times more in the north and two times more in the south). Delay in diagnosis as compared to the first symptoms occurence was 21 months and during that time no patients were treated with DMARDS.
Zlatkovic-Svenda MI, Stojanovic RM, Milenkovic MP, Vlajinac HD, Le Bihan E, Guillemin F. Adaptation and validation of a telephone questionnaire – Serbian version for case detection of rheumatoid arthritis and spondyloarthropathy (multicentric Eular study). Clin Exp Rheumatol. 2007;25 (1): 75–84.
Disclosure of Interest None declared
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