Access to Immunological Markers for the Management of Rheumatoid Arthritis in Togo with Regard to 2010 ACR/EULAR Classification

Background:The American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) jointly defined new criteria for rheumatoid arthritis (RA) in 2010.This classification has made several changes to immunological markers.Objective:To determine access to rheumatoid factors (RF), antibodies against cyclic citrullinated peptide (anti-CCP), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) inrheumatology field in Togo.Materials and methods:This is a cross-sectional study including patients with RA and follow-up between 1990 and 2016.Patient records were used to collect data, especially age at diagnosis, sex, date of diagnosis, ESR, CRP, RF and anti-CCP.These data were entered and analyzed using Epidata and Epi-Info7.Patients whose diagnosis was made between 1990 and 2010 were distinguished from those diagnosed between 2011 and 2016.Results:Out of the 125 patients included in this study, 57.6% were diagnosed between 1990 and 2010.The mean age at diagnosis was 44.5 ± 14.7 years.Women represented 88% of the patients corresponding to a sex-ratio F:M of 7.3:1.ESR was available in all patients and increased in 92% of them.The mean ESR was 71 ± 33.9 mm.CRP was available only in 7 (5.6%)patients and was elevated in four of them.The RF was performed in 10 (8%) patients and was positive in four of them.Anti-CCP were performed only in six (4.8%) patients and were present in only one patient.Compared to patients diagnosed between 1990 and 2010, access to CRP, RF and anti-CCP has not been improved in our patients after 2010.Conclusion:Apart from the ESR, access to other immunological markers of 2010 ACR/ EULAR criteria is very low.This is responsible for delay of diagnosis and treatment of RA in Togo.