What you need to know:
- Prevention: An active lifestyle and a balanced diet can save you from this painful and debilitating illness.
- Taking a few minutes everyday to give your body a workout will keep athritis at bay. Read on...
Arthritis is an inflammation of the joints that can cause devastating joint pain which can be so severe to a patient. The disease, according to health experts is caused by normal wear and tear, body attacks on the immune system, infection and injury among others.
Dr James Elima, the Director Gulu Regional Referral Hospital, notes that among female patients, the disease is commonly caused by hormonal imbalance. “During menstrual period women experience amino acid concentration in the urine which spreads to the joints. Also the use of certain family planning drugs may result into such inflammation in the joints,” says Dr Elima.
The experts intimate that there are more than 100 different kinds of arthritis and related conditions affecting patients across the globe including Uganda.
Arthritis just like other non-communicable diseases is becoming prevalent as experts focus their attention on the fight against Covid- 19.
Why we hear less about non-communicable diseases
Dr Mallon Nyati, a consultant in orthopedics surgery from Mulago Hospital notes that health experts tend to put more emphasis in controlling communicable diseases than non-communicable ones.
“As health experts we give more attention to infectious diseases because they spread from one person to another through close contact. They cause high mortality and morbidity rate leading to panic. They therefore, get quick attention by health experts and governments because they can actually be controlled,” says Dr Nyati.
Dr Nyati contends that major focus has been put in primary health care in controlling diseases such as malaria, cholera among others because it is cheap to implement in terms of costs and public measures can be implemented.
“But non-communicable diseases are lifestyle diseases which do not kill directly, patients can live with them for such a long time and actually die from other disease infections. Also, they are difficult to manage and the treatments are expensive. This is why the burden is left on the individual,” he notes.
Types of arthritis
Dr Nyati puts the disease in two categories namely; infective arthritis such as chromatin arthritis which he says affects mainly the young children because of their weaker immune system. Although the number of children suffering from this is verse across the globe, in Uganda it is on a very minimal rate.
The second category is degenerative types of arthritis which he says are common in adults and aging people. These are types which affect people due to their lifestyle and genetic makeup.
Also called degenerative arthritis, is the commonest type. Its symptoms include the cartilage in the joints breaking down, eventually causing the bones to rub together due to inflammation with subsequent pain, bone injury and bone outgrowth formation.
It may occur in just one or two joints, on one side of the body. Age, obesity, injuries, family history increase the risk of getting this type of arthritis. It is usually diagnosed using x-ray images and testing of sample fluids to establish presence of arthritis and the infection rate.
In this type of arthritis, the body attacks healthy joint tissue. In most cases both joints are affected and this may end up affecting the heart, lungs, eyes causing dry eyes and mouth. It leads to difficulty in sleeping.
To diagnose this form of arthritis patients need anti-cyclic citrullinated peptide, complete blood count and reaction of body protein test.
As the name suggests, juvenile idiopathetic arthritis affects children younger than 16 years. It causes muscle and soft tissue to tighten, bones to erode, growth patterns to change and joints to misalign.
Gout is a form of arthritis caused by the accumulation of urate crystals inside one’s joints. It is caused by a biochemical abnormality in the body.
Dr Nyati stresses that unlike the common misconception, consuming of red meat or alcohol does not cause gout. However, if consumed in excess, red meat may lead to too much protein in the body thereby attracting other diseases to affect the joint.
“When a person consumes excess protein which is comprised of amino acid, this needs to be expelled through urine but if it becomes concentrated, it is likely that the crystals end up in the joints causing gout,” says Dr Nyati.
Gout, he said is not common in Uganda, and it is more common in men than women.
Infectious and reactive arthritis
This is an infection in one of the joints that causes pain or swelling. The infection can be caused by bacteria, viruses, parasites or fungi. It can start in another part of the body and spread to the joints accompanied by fever.
The reactive type can occur when an infection in one part of your body triggers immune system dysfunction and inflammation in a joint elsewhere in your body. The infection often occurs in the gastrointestinal tract, bladder or sexual organs.
Patients speak out
Saidhia Angucia, 38, a resident of Mbuya Zone II says she was diagnosed with osteoarthritis in 2018. She used to experience swollen knees but after treatment the pain is less frequent. Occasionally the pain comes in the joints for which she takes painkillers.
Christine Adoch, 58, a resident of Atiak in Gulu says doctors at Gulu Regional Referral Hospital diagnosed her with Rheumatoid Arthritis in 2017. Because it was already in a severe state she underwent an operation to extract fluid which was effective.
According to statistics from World Health Organisation, non-communicable diseases including arthritis affect about one per cent of the population. Dr Elima says he treated 46 patients last year; those suffering from general arthritis were 16 cases, those suffering from septic arthritis caused by injuries were five and those suffering from Osteoarthritis were 25.
There were no deaths and in most cases hospitals upcountry register very minimum cases, he notes.
Dr Nyati notes that in Uganda, there is no concrete data regarding patients suffering from the various types of arthritis. Usually health workers rely on research carried out by health experts and students on case by case basis.
Citing a study done by a group of scientists in Entebbe, Mityana and Nakaseke where 267 patients were sampled, it indicated that 59.6 per cent with injuries had the possibility of developing joint arthritis.
The causes and treatment options available vary from one type of arthritis to another.
Dr Nyati, recommends carrying out reasonable exercise to keep the joints fit. The exercise must not be excessive leading to joint injuries which may result into disease infection because ligaments and cartilages may get damaged.
“For instance excessive sports activities such as athletics and football among others may lead to injuries and such sports persons may end up contracting arthritis in later age,” he says.
Some cases can be managed through treatment but surgery is recommended to drain off the accumulated liquid as well as replacement of knee bones with artificial bones for severe ones.