Prevalence of rheumatoid arthritis among hospital workers in the north of Jordan: Preliminary report of a hospital-based cohort study

Background

Rheumatoid arthritis (RA) is the most common autoimmune inflammatory arthritis in adults. Prevalence estimates of rheumatoid arthritis vary in the world. Occupational factors and geographical location might contribute to a higher risk of developing the disease, however the exact etiology remains unknown.

The aim of our study was to estimate the prevalence of RA among hospital workers in the North of Jordan and to compare this prevalence with that in the general population. In addition to describing the characteristics of RA patients.

Methods

The study was performed in two stages; during the first stage a specially designed questionnaire was conducted by trained residents with 2569 hospital workers from 6 government hospitals to identify individuals with RA. Suspected individuals of having RA identified in stage one were invited and examined further by two rheumatologists for confirmation of the diagnosis.

Results

A total of 2569 employees were interviewed; among them 1240 (48.5%) were males and 1318 (51.5%) were females. The mean (SD) age was 34±(8.4) years. In the second stage the diagnosis of RA according to ACR criteria 1987 was confirmed in 8 individuals (2 males and 6 females). Male: Female (M: F) ratio was 1:3 with mean (SD) age 43.38 (7.52) years. The estimated prevalence of RA among hospital workers in the North of Jordan was 8/2569 = 0.00311, 31.1:10.000, 0.31%, (95% confidence interval, 9.6–52.7:10.000).

Conclusion

The prevalence of RA among hospital workers in the North of Jordan is 0.31%, similar to that of other parts of Jordan and neighboring regions.

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Rheumatoid arthritis is a chronic disabling disease.

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Data regarding RA in Jordan is very limited. We conducted this study to shed light on how widespread RA.

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Our study showed similar prevalence of RA in surrounding regions, suggesting influence of environmental and occupational factors.

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We hope this may help advance patient care and management.

The prevalence of Behçet's disease in the north of Jordan: a hospital-based epidemiological survey

OBJECTIVES

To estimate the prevalence of Behçet's disease (BD) in Jordan, with the additional aim of comparing this prevalence among hospital workers in other geographical areas.

METHODS

In the first stage of our survey, 2,569 employees from 6 hospitals in north Jordan were interviewed using a screening questionnaire to identify individuals with recurrent oral ulcers (ROU), a previous diagnosis of BD (PDBD) and/or any major symptom related to BD. In the second stage, all individuals with ROU or PDBD identified at stage 1, were examined by 2 rheumatologists for the presence/confirmation of BD according to the International Study Group (ISG) criteria. Pathergy test was performed according to recommendations.

RESULTS

ROU were present in 210 (8.2%) individuals. BD was confirmed in 10 employees with PDBD. Seven more BD patients were found. Mean age of 17 BD patients was 38.6±10.7 (range 26-65 y). M: F was 2.4:1. Pathergy test was positive in 8/17. A family history of ROU or BD was noted in 9 (52%) and 3 (25.0%), respectively, compared to 227 (8.9%) and 62 (2.6%) in the whole group, excluding the BD patients (p<0.001 and 0.008, respectively). The prevalence rate of BD in the north of Jordan was estimated as 66:10.000 (95% CI 34.8 to 97.5:10000).

CONCLUSIONS

The results of this first ever survey indicated that the prevalence of BD in the north of Jordan is among the highest in the world. This prevalence can now be compared to hospital workers in other geographical areas.

Endocarditis with left atrial thrombus formation in Behçet's disease mimicking myxoma

A 51-year-old male patient with Behçet's disease had a large echogenic mass in the left atrium mimicking myxoma, documented by echocardiography. Postoperative pathological examination revealed left atrial thrombus, deep ulcerations of mitral valve leaflets with signs of active endocarditis. Cardiac evaluation with echocardiography should be considered in patients with Behçet's disease.