Clinical Rheumatology

, Volume 29, Issue 6, pp 593–597

Rheumatoid arthritis among Nigerians: the first 200 patients from a rheumatology clinic

  • Olufemi O. Adelowo
  • Osaze Ojo
  • Irene Oduenyi
  • Chibuzo C. Okwara
Original Article


Rheumatoid arthritis has uncommonly been reported among Africans and rarely among West Africans. Most of the reported cases have been from Southern Africa. A recent awareness of increased reports of RA among Nigerians necessitated this study. The objective of this retrospective study was to identify the clinical presentations, laboratory characteristics as well as treatment regimens of Nigerians presenting with rheumatoid arthritis to a private rheumatology clinic in Lagos, Nigeria. This is a retrospective study of consecutive rheumatoid arthritis patients seen over a period covering 7 years and 10 months diagnosed using the ARA Criteria for RA. Laboratory tests and radiographic investigations were carried out. Treatment was with NSAIDs, prednisolone, disease modifying anti-rheumatic drugs (DMARDs), and biologics. RA accounted for 12.3% of a total of 1,623 patients presenting to the clinic with rheumatologic complaints over the study period. Females were mostly affected (F:M—2.4:1) and mean age is 46.9 years. Duration of symptoms before presentation was 4–264 months with a mean of 63.4 months. The proximal interphalangeal joints were mostly involved. Subcutaneous nodules were seen in 29.5% of the cases while rheumatoid factor was found in 38.5% of the subjects. ESR was mostly elevated and radiographic changes were mostly mild with 29.2% showing erosive changes on radiographs of the hands. Treatment was variously with non-steroidal antiinflammatory drugs (NSAIDs), prednisolone, and DMARDs. Rheumatoid arthritis is not uncommon among Nigerian; and clinical, serologic acumen are necessary for early diagnosis and appropriate referral.


Nigerians Rheumatoid arthritis Rheumatology clinic 


  1. 1.
    Symmons DPM, Barrett EM, Bankhead CR et al (1994) The occurrence of rheumatoid arthritis in the United Kingdom: results from the Norfolk Arthritis Register. Br J Rheumatol 33:735–739CrossRefPubMedGoogle Scholar
  2. 2.
    Silman AJ, Hochberg MC (1993) Epidemiology of the rheumatic diseases. Oxford University Press, OxfordGoogle Scholar
  3. 3.
    Alamanos Y, Drosos AA (2005) Epidemiology of adult rheumatoid arthritis. Auto immune Rev 4:130–136Google Scholar
  4. 4.
    Solomon L, Beighton P, Valkenburg HA et al (1975) Rheumatic disorders in the South African Negro. Part 1. Rheumatoid arthritis and ankylosing spondylitis. S Afr Med J 49(32):1292–1296PubMedGoogle Scholar
  5. 5.
    Solomon L, Robin G, Valkenburg HA (1975) Rheumatoid arthritis in an urban South African Negro population. Ann Rheum Dis 34(2):128–35CrossRefPubMedGoogle Scholar
  6. 6.
    Chikanza IC, Stein M, Lutalo S et al (1994) The clinical, serologic and radiologic features of rheumatoid arthritis in ethnic black Zimbabwean and British Caucasian patients. J Rheumatol 21(11):2011–2015PubMedGoogle Scholar
  7. 7.
    Mody GM (1995) Rheumatoid arthritis and connective tissue disorders: Sub Saharan Africa. Baillieres Clin Rheumatol 9(1):31–34CrossRefPubMedGoogle Scholar
  8. 8.
    Mody GM, Meyers OL (1989) Rheumatoid arthritis in blacks in South Africa. Ann Rheum Dis 48(1):69–72CrossRefPubMedGoogle Scholar
  9. 9.
    McGill PE, Oyoo GO (2002) Rheumatic disorders in Sub-Saharan Africa. East Afr Med J 79(4):214–216PubMedGoogle Scholar
  10. 10.
    Adebajo A, Davis P (1994) Rheumatic diseases in African blacks. Semin Arthritis Rheum 24(2):39–53CrossRefGoogle Scholar
  11. 11.
    Mijiyawa M (1993) Rheumatic diseases in black Africa. Rev Rheum (Ed fr) 60(6):451–457Google Scholar
  12. 12.
    Adelowo OO (1985) Arthritis in adult Nigerians. Niger Med Pract 10(3):69–71Google Scholar
  13. 13.
    Adelowo OO (2007) Rheumatoid arthritis and Connective tissue diseases among Nigerians. Clin Rheumatol 26:18–19Google Scholar
  14. 14.
    Arnett FC, Edworthy SM, Bloch DA et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324CrossRefPubMedGoogle Scholar
  15. 15.
    Okoye RC, Williams E, Alonso A et al (1985) HLA polymorphisms in Nigerians. Tissue Antigens 25:142–155PubMedCrossRefGoogle Scholar
  16. 16.
    Silman AJ, Ollier W, Holligan S et al (1993) Absence of rheumatoid arthritis in a rural Nigerian population. J Rheumatol 20(4):618–622PubMedGoogle Scholar
  17. 17.
    Greenwood BM, Herrick EM, Voller A (1970) Can parasitic infections suppress autoimmune disease? Proc R Soc Med 63(1):19–20PubMedGoogle Scholar
  18. 18.
    Adelowo OO, Oguntona SA (2009) Pattern of systemic lupus erythematosus among Nigerians. Clin Rheumatol 28:699–703CrossRefPubMedGoogle Scholar
  19. 19.
    Ravindran V, Seah MA, Elias DA et al (2008) Clinical and radiological features of rheumatoid arthritis in British black Africans. Clin Rheumatol 27(1):97–100CrossRefPubMedGoogle Scholar
  20. 20.
    Wisnieski JJ, Askan AD (1981) Rheumatoid nodulosis: a relatively benign rheumatoid variant. Arch Intern Med 141:615–619CrossRefPubMedGoogle Scholar

Copyright information

© Clinical Rheumatology 2010

Authors and Affiliations

  • Olufemi O. Adelowo
    • 1
    • 5
  • Osaze Ojo
    • 2
  • Irene Oduenyi
    • 3
  • Chibuzo C. Okwara
    • 4
  1. 1.Rheumatology Unit, Department of MedicineOlabisi Onabanjo University Teaching HospitalSagamuNigeria
  2. 2.Department of MedicineUniversity of Benin Teaching HospitalBeninNigeria
  3. 3.Arthrimed Specialist ClinicLagosNigeria
  4. 4.Department of MedicineUniversity of Nigeria Teaching HospitalEnuguNigeria
  5. 5.LagosNigeria

Personalised recommendations