Abstract
Background & Objective: The lag time of diagnosis of axial spondyloarthrits varies from country to country. The aim of this study was to find out the lag time of diagnosis of axial spondyloarthritis in Bangladesh based on the patients visiting the morning Rheumatology OPD of a tertiary-care hospital. Materials & Methods: This study was conducted in the Department of Rheumatology of Enam Medical College & Hospital, Savar, Dhaka, Bangladesh from October, 2018 to December, 2019. Ninety six patients with axial spondyloarthritis were recruited and they were enquired about their ages, places of residence, educational qualifications and duration of axial pain as well as peripheral pain. The participants also underwent estimation of ESR by Westergren method. Results: Mean age of the participants was 39.98 years. The mean and median lag times of diagnosis were 58.17 and 36 months respectively. The lag time of diagnosis followed a nonnormal (right-skewed) distribution. There was no significant difference between males and females (p≈0.921), between rural and urban participants (p≈0.221), between those with and without peripheral involvement (p≈0.387) as well as between those with and without elevated ESR according to Mann-Whitney U test. But the median lag time in those who were highly educated, ie. those who completed at least a bachelor degree was significantly (p≈0.016) shorter than that in those who were not highly educated. Conclusion: There is a considerable median delay in the diagnosis of axial spondyloarthritis in Bangladesh. Further research is required to identify the factors contributing to the delay so that those can be addressed to shorten the lag time.
Highlights
The spondyloarthritis (SpA) family comprises ankylosing spondylitis (AS), nonradiographic axial SpA, peripheral SpA, psoriatic arthritis, SpA associated with Crohn’s disease and ulcerative colitis, reactive arthritis and juvenile-onset SpA
The female preponderance of the respondents may be explained by the fact that they were picked up mainly during the morning OPD hours when most of the males have to stay in the workplace
There was no significant difference between males and females as well as between rural and urban residents with regard to median lag times
Summary
The spondyloarthritis (SpA) family comprises ankylosing spondylitis (AS), nonradiographic axial SpA (nr-axSpA), peripheral SpA, psoriatic arthritis, SpA associated with Crohn’s disease and ulcerative colitis, reactive arthritis and juvenile-onset SpA. The major clinical features which differentiate spondyloarthritis (SpA) from other forms of arthritis are the distribution and type of musculoskeletal manifestations and certain extraarticular features. The lag time of diagnosis of axial spondyloarthrits varies from country to country. The aim of this study was to find out the lag time of diagnosis of axial spondyloarthritis in Bangladesh based on the patients visiting the morning Rheumatology OPD of a tertiary-care hospital. Ninety six patients with axial spondyloarthritis were recruited and they were enquired about their ages, places of residence, educational qualifications and duration of axial pain as well as peripheral pain. The mean and median lag times of diagnosis were 58.17 and 36 months respectively. The median lag time in those who were highly educated, ie. Conclusion: There is a considerable median delay in the diagnosis of axial spondyloarthritis in Bangladesh. Further research is required to identify the factors contributing to the delay so that those can be addressed to shorten the lag time
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