Prevalence of arthritis in India and Pakistan: a review

Abstract

Recent studies of rheumatoid arthritis worldwide suggest that prevalence of arthritis is higher in Europe and North America than in developing countries. Prevalence data for major arthritis disorders have been compiled in West for several decades, but figures from the third world are just emerging. A coordinated effort by WHO and ILAR (International League Against Rheumatism) has resulted in collecting data for countries like Philippines, China, Malaysia, Indonesia, and rural South Africa but the information about prevalence of arthritis in India and Pakistan is scarce. Since both countries, i.e., India and Pakistan, share some ethnic identity, we reviewed published literature to examine the prevalence of arthritis in these countries. Medline and Pubmed were searched for suitable articles about arthritis from 1980 and onwards. Findings from these articles were reviewed and summarized. The prevalence, clinical features, and laboratory findings of rheumatoid arthritis are compiled for both India and Pakistan. Data collected from these two countries were compared with each other, and some of the characteristics of the disease were compared with Europe and North America. It is found to be quite similar to developed countries. Additionally, juvenile rheumatoid arthritis is of different variety than reported in West. It is more of polyarticular onset type while in West pauciarticular predominates. Additionally, in systemic onset, JRA uveitis and ANA are common finding in developed countries; on the other hand, they are hardly seen in this region. Although the prevalence of arthritis in Pakistan and India is similar to Western countries, there are inherent differences (clinical features, laboratory findings) in the presentation of disease. The major strength of the study is that it is the first to pool reports to provide an estimate of the disease in the Indian subcontinent. Scarcity of data is one of the major limitations. This study helps to understand the pattern of disease in this part of country that can be stepping-stone for policy makers to draft policies that can affect target population more appropriately.

Polyarticular juvenile idiopathic arthritis – epidemiology and management approaches

“…Epidemiological studies have reported a wide variance in different regions of the world, with low rates in Asian populations14,15 and relatively higher frequencies in those of European descent 16,17. Vast differences also appear within the same country as demonstrated by polyarticular disease occurring more frequently in southern India as compared to the northern region 18. Considering all subtypes of arthritis, the incidence of childhood arthritis ranges from 0.83 per 100,000 children in Japan14 to 23 per 100,000 in Norway 19.…”

Literature review of rheumatoid arthritis in India

“…In developing countries (Oman, China, Argentina, Yugoslavia), the prevalence was lower, ranging from 1.8 per 1000 in the former country of Yugoslavia to 3.6 per 1000 in Oman. In a comparison of RA in India and in Pakistan by Akhter et al ., the prevalence of RA in Pakistan (5/1000) fell within the range presented for India (2/1000 through 10/1000). In the studies we present, the RA prevalence, based on the ACR criteria, ranged from 2.8 per 1000 to seven per 1000, suggesting that prevalence may vary throughout India as much as it varies throughout Europe and could be comparable to prevalence in the Western world.…”

Rheumatoid Arthritis Related Interstitial Lung Disease: Patterns of High-resolution Computed Tomography

“…Rheumatoid arthritis (RA) is a chronic inflammatory systemic disease exhibiting clinical signs and symptoms of predominantly joint disease [1][2][3]. This disease is characterized by symmetrical bilateral involvement of mostly small joints of hand and feet; however as it leads to chronic synovitis, all joints may be involved [4][5].…”