Rheumatic diseases, lupus must be identified early: Experts

Participants pose for a photograph at a roundtable titled "Rheumatic Diseases and Lupus: World Class Treatment Needed” at the Prothom Alo office in the capital’s Karwan Bazar on 9 July, 2023Prothom Alo

There are different types of rheumatic diseases. Therefore the type of rheumatic disease the patient is suffering from should be identified and treatment should be started following the advice of the physician. A patient should not use drugs on whim to reduce the pain.

Lupus is a type of rheumatic disease which causes acute joint pain and damages different parts of the human body. Planned lifestyle and proper treatment help keep the complications of rheumatic diseases under control. Modern treatment of such diseases is available in Bangladesh.

Specialist physicians said this at a roundtable titled “Rheumatic Diseases and Lupus: World Class Treatment Needed” at the Prothom Alo office in the capital’s Karwan Bazar on Sunday.

The Lupus Foundation of Bangladesh, Bangladesh Rheumatology Society and the Rheumatology Department of the Bangabandhu Sheikh Mujib Medical University (BSMMU) jointly organised the roundtable in association with the International League of Associations for Rheumatology (ILAR).

The speakers at the roundtable further said that an increased amount of uric acid in the body does not always mean gout. Similarly, all joint pain does not necessarily indicate a deficiency of calcium.

Therefore, massive awareness should be created about the disease. The scientists are yet to discover the reasons behind the diseases like rheumatoid arthritis and lupus.

The speakers at the roundtable further said that for the first time, proposals have been made to include musculoskeletal pain, muscle pain and other related diseases in the 5th Health Nutrition and Population Sector Program (HNPSP).

BSMMU Vice-Chancellor Professor Dr. Md Sharfuddin Ahmed said there are several types of the painful illness. These types of patients have to spend a lot for long term treatments. Therefore, arrangements should be made to ensure medicine at a low cost for the patients. Besides, specialist doctors should be appointed in hospitals outside Dhaka for the treatment of this painful illness. There should be a scope to use the unused portion of the fund allocated for one specific health sector for other sectors, he added.

President of Lupus Foundation of Bangladesh and Bangladesh Rheumatology Society, Professor Dr. Syed Atiqul Haque said, “There are only 73 rheumatologists in the country at the moment. Most of them are Dhaka-based. Rheumatology specialists and nurses should be appointed to all district level hospitals and medical colleges gradually.”

Referring to a research on the rheumatic disorders and related disabilities in Bangladesh published in PubMed in 2020, he said, "More than 30 per cent of the participants in the survey had rheumatic conditions. The rate of women arthritis patients is 10 per cent higher as compared to male patients. In 25 per cent cases of arthritis, patients developed different levels of disabilities later."

Professor Dr. Mohammad Robed Amin, Line Director of Non-Communicable Disease Control (NCDC) programme of Directorate General of Health Services, said the NCDC had proposed to include rheumatic diseases in the 5th HNPSP to make government arrangements for treating rheumatic patients. Besides, a guideline is being prepared to treat the patients of rheumatic fever. It will help the patients to reduce the cost for the treatment.

Referring to the example of a 30-year old rheumatoid arthritis and lupus patient, the Asia Pacific League of Associations for Rheumatology’s Secretary General and Bangladesh Rheumatology Society’s Vice President Professor Dr. Md Nazrul Islam said that the patient has suffered from acute pain.

Later he was diagnosed with diabetes as rheumatic condition gives rise to other diseases. Being unable to work due to severe pain, the person lost his job.

Mr. Nazrul Islam said rheumatic disease does not kill people but it affects the life of patients adversely.

Professor Dr. Minhaz Rahim Choudhury, Chairman of Rheumatology department of BSMMU and President-elect of Bangladesh Rheumatology Society said there are 693 types of rheumatic conditions. But people do not pay much heed to pain and think that only exercise can cure it. Many people mistakenly think any joint pain is rheumatic fever. But it is one of the many types of rheumatic diseases. Bangladesh now has advanced treatment of rheumatic diseases and it could be controlled through early intervention, if not fully cured.

Rezwana Choudhury Bannya, eminent singer and Trustee of Tagore University of Creative Arts, stressed on enhancing social awareness on the disease using technology and social media.

Dr. Nasrin Sultana, Professor and Director of Dhaka University's Institute of Health Economics, said individuals bear 69 per cent treatment cost in the country. It has to be found out how much people are spending on treatment of rheumatic diseases. A specialised government hospital should be established for treating the RA patients.

Bangladesh Rheumatology Society’s deputy secretary general Abu Shahin said timely intervention and proper treatment can save a RA patient from disability. Many people mistake RA for calcium-deficiency and take medicine for gout while suffering from uric acid. Such wrong medication becomes harmful instead of doing good.

Bangladesh Rheumatology Society’s executive member Professor Dr. Shahana Akter Rahman said many children suffer from neck pain from carrying school bags with excessive weight, taking processed food and lack of physical activities.

She further said children suffer from Juvenile Idiopathic Arthritis (JIA) but most of the cases are misdiagnosed. Many children suffer from growing pains which many parents misunderstand as rheumatic fever.

Bangladesh Rheumatology Society’s treasurer Professor Dr. Rowsan Ara Swapna said many people consume painkillers without diagnosis, which is very harmful. She suggested a specialised hospital for rheumatic conditions with skilled human resources and a guideline for treatment of the disease.

A lupus patient named Syeda Maria Affendi said she has to spend Tk 16,000 every month on treatment. Family’s cooperation is of utmost importance for this disease, she added.

Lupus Foundation of Bangladesh’s Secretary General Farhana Ferdous said women are more susceptible to some types of rheumatic conditions such as lupus. This is a multi-system life-time disease and affects other vital organs of the body. Although this disease requires long-term treatment, many cannot continue it. There should be institutional arrangements to create nationwide awareness and reduce treatment costs.

In his welcome speech, Prothom Alo’s associate editor Abdul Quayum said many people do not know rheumatic diseases and lupus are serious diseases.

Prothom Alo’s assistant editor Firoz Choudhury moderated the roundtable.