Rheumatoid Arthritis in Syria: Knowledge and Awareness among the General Population

doi:10.21203/rs.3.rs-2194091/v2

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Rheumatoid Arthritis in Syria: Knowledge and Awareness among the General Population

https://doi.org/10.21203/rs.3.rs-2194091/v2

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Introduction: Rheumatoid arthritis (RA) is an autoimmune inflammatory disease that mainly attacks the joints symmetrically, in addition to other systems. Recurrent attacks result in chronic pain, joint deformity, and decreased quality of life. The aim of this study aim was to identify beliefs and assess knowledge about this disease in the general population.

Methods: 1439 Syrian participants completed an online Google Forms questionnaire comprised of 13 true-false questions designed to evaluate knowledge regarding rheumatoid arthritis, as well as questions about demographic, social, clinical, and behavioral characteristics.

Results: Roughly 60% of the participants knew about RA to some extent, while nearly a quarter had no prior knowledge about the disease.

One third of the respondents were very knowledgeable about RA, a quarter were moderately knowledgeable, 14% had a low level of knowledge,, and 28% had a very low level of knowledge.

Conclusion: Knowledge about rheumatoid arthritis in Syria was found to be flawed and lacking. Our study suggests that the general population requires further education about the disease. Health-professionals should take care to better educate their patients, and community education campaigns to increase awareness should address the knowledge deficit among the population at large.

Rheumatology

Knowledge

rheumatic diseases

Rheumatoid arthritis

Syrian population

Rheumatoid arthritis (RA) is an autoimmune inflammatory disease that mainly attacks the small joints symmetrically, especially those in the hands, wrists, and feet, but other joints maybe affected, in addition to other systems. Recurrent attacks cause chronic pain, joint deformity, and decreased quality of life (1).

The prevalence is about 0.24% (2) and twice as common in women compared to men, with a peak incidence between age 65 to 80 years of age (3).

Rheumatoid arthritis (RA) is the result of an immune response in which the body’s immune system attacks its own healthy cells, especially the synovium, which is infiltrated by innate immune cells like monocytes, dendritic cells, and mast cells, and adaptive immune cells like T-helper 1, T-helper 17, B cells, and plasma cells, and cytokines and granulocyte-monocyte colony-stimulating factors (1, 4).

The RA etiology is unknown, but some factors can be a risk of developing RA, like age, female sex, genetic traits, and smoking. Multiple studies show that some factor may worse the disease course like the history of live births, early life exposures, and obesity, meanwhile; women who have breastfed their infants have a decreased risk of developing RA(1).

The symptoms and signs include: arthralgia, arthritis, Stiffness in more than one joint, fatigue, weight loss, fever, and other systems manifestations (5).

RA is diagnosed according to the American college of Rheumatology and European League against Rheumatism 2010 criteria (4), which contain symptoms, signs, lab tests, and X-rays.

The treatment should begin early—within 6 weeks of the onset of symptoms to slow or stop disease progression by achieving long-term remission, and to optimize quality of life (1, 7).

The treatment includes analgesics, steroids, disease-modifying anti-rheumatic drugs (DMARDs); and biologics(1.8),in addition to nutritional supplements and dietary changes, physical and occupational therapy, Lifestyle remedies, and surgery(9, 10).

RA has many consequences such as recurrent attacks or chronic pain, disability, decreased quality of life, osteoporosis, and cardiovascular disease which can cause premature death (11.12).

Providing agood quality information is important in RA (13), because it can lead to changes in attitudes and behaviors, and promote self-management skills, providing a better health status (14.15).

Patient participation in health care is very important, patients should be well informed about diagnosis, management including therapeutic decisions and prognosis (16, 17), especially regarding chronic or life threatening disease (18).

The aim of our study was to explore the knowledgment about rheumatoid arthritis in the Syrian population, as the overall level of information about rheumatic diseases is low among patients living as demonstrated by studies (16–19).

In our cross-sectional study, 1439 participants over 18 years old were selected from out hospital patents in Al-Moussat University Hospital, Damascus, Syria fromFeb2022 toJuly2022.Thy were interviewed to collected information, using a standard protocol that comprised multiple questionnaires and exams. Recruitment at baseline was done using random digit dialing. The baseline data include demographic, social, clinical, and behavioral characteristics, an interviewer-administered questionnaire, comprising 13 statements about rheumatoid arthritis to be considered true or false, taken from Rheumatoid Arthritis Knowledge Assessment Scale (RAKS), designed to evaluate knowledge regarding rheumatoid arthritis (20) after translated it by 2 independent professional translators to create a consensus version. This statement includes: its symptoms, the etiology, the risk factors, and the treatment.Informed written consent carried out in accordance with the Helsinki Declaration was signed by all participates in our study.

Statical analysis

The statistical study was conducted using the SPSS program. Demographic data were described as percent and/or standard deviation. The Chi-Square test was used for qualitative variables. The Rheumatoid Arthritis Awareness Rating Scale was calculated, in which each wrong answer = 0, and each correct answer points = 1, then participants were divided into four levels according to this scales: excellent level > 70%, moderate level 50–70%, low level > 30 - <50%, and low level < 30%. P < 0.05) was considered as a statistical significance

1-Demographic data

Out of 1439 participants, 57.3% were female, 42.7% were male, and 28.6% were

Of this among the age groups was 18–24 years, and 18.1% among the age groups was 45–54 years, respectively.

42.7% of participants were from Damascus, and 23.3% from Damascus suburb.

Most of the participants (46.9%) had university degree, and 21.7% of the participants didn't get a baccalaureate.The majority was single (44.8%), meanwhile (41.8%) were married. 31.4% were students and 21.6% were employees. 42.4% of participants with good economic status(Table-1),and (Figures:1,2,3).

Table-1

Demographic characteristics of participants

Age(years)
18 > yr.	112(7.8%)
18–24	411(28.6%)
25–34	232(16.1%)
35–44	247(17.2%)
45–54	261(18.1%)
>54	176(12.2%)
Gender
Male	614(42.7%)
Female	825(57.3%)
Residence
Damascus	413(28.7%)
Rural Damascus	336(23.3%)
Aleppo	53(3.7%)
Homs	74(5.1%)
Hama	34(2.4%)
Latakia	54(3.8%)
Edlib	54(3.8%)
Tartous	39(2.7%)
Deir Alzor	60(4.2%)
Alraqa	45(3.1%)
Al-Hasakeh	46(3.2%)
Qamishli	41(2.8%)
Suwayda	62(4.3%)
95 (6.6%)Daraa	95(6.6%)
Quneitra	33(2.3%)
Educational level
Less than a high school diploma (baccalaureate)	(21.7%)312
Baccalaureate	98(6.8%)
University	675(46.9%)
Master's	103(7.2%)
Doctorate	38(2.6%)
Non-educated	213(14.8%)
The University branches
Medicine	275(19.1%)
Pharmacy	61(4.2%)
Dentistry	32(2.2%)
Nursing	24(1.7%)
College of science	49(3.4%)
College of Engineering	65(4.5%)
College of literature	99(6.9%)
Business Academy	84(5.8%)
College of law	38(2.6%)
College of Arts	33(2.3%)
Business Management	75(5.2%)
Not a college student	602(41.8%)
Academic year
First	52(3.6%)
Second	65(4.5%)
Third	42(2.9%)
Fourth	74(5.1%)
Fifth	60(4.2%)
Sixth	114(7.9%)
Graduate	434(30.2%)
Without a degree	507(35.2%)
At school	91(6.3%)
Marital Status
601 (41.8%)Married	601(41.8%)
644 (44.8%)Single	644(44.8%)
147 (10.2%)Divorced	147(10.2%)
47 (3.3%)Widow	47(3.3%)
The work
311 (21.6%) Employee	311(21.6%)
271 (18.8%)Private business	271(18.8%)
197 (13.7%)House wife	197(13.7%)
Student	452(31.4%)
Retired	38(2.6%)
Unemployed	170(11.8%)
Financial status
Excellent (enough for basic needs and luxuries)	125(8.7%)
Very good (enough for basic needs and some luxuries)	422(29.3%)
Good (enough for basic needs)	610(42.4%)
Bad (not enough for basic needs)	282(19.6%)

2- Knowledge about Rheumatoid Arthritis

59.3% of the participants knew about rheumatoid disease to some extent, while 23.3% did not know any information about the disease before. 78% of the participants knew that joint pain is a symptom of rheumatoid arthritis, and 40.4% of the participants knew that a family history of rheumatoid arthritis is a risk factor for developing rheumatoid arthritis.

39.6% knew that RA does not only affect the bones or joints, 52.7% said that RA causes physical disability, 50% knew that rheumatoid arthritis can cause deformation of the joints, 49.8% knew that it is inherited from the parents, 67.4% knew that RA cannot spread from person to person, and 53.8% knew that the disease affects female sex more, and meanwhile, 56.4% also knew that the erythrocyte sedimentation rate is one of the most common assessments of disease.

Moreover, 43.1% knew that RA can be cured completely, 49.1% knew that the disease requires lifelong treatment, and 35.9% knew that physical therapy is useful in treating the disease. All this data are showed in Table-2, and Fig. 4,5,6

Table-2

Knowledge about Rheumatoid Arthritis

1. Do you know what rheumatoid arthritis is?
Yes, well aware of it	249(17.3%)
Yes, sort of	854(59.3%)
No	336(23.3%)
2. Which of the following is a symptom of RA
11 (0.8%) low blood glucose	11 (0.8%)
1123 (78%) joint pain	1123(78%)
18 (1.3%) Drowsiness	18(1.3%)
25 (1.7%) High blood pressure	25(1.7%)
262 (18.2%)	262(18.2%)
3. Which of the following is a risk factor for RA
Hypertension	66(4.6%)
High glucose level	53(3.7%)
Family history of diabetes in the parents	66(4.6%)
Family history of rheumatoid arthritis	582(40.4%)
I don't know	672(46.7%)
4. In your opinion, does RA only affect the joints and/or bones in the body:
Yes	393(27.3%)
No	570(39.6%)
I don’t know	476(33.1%)
5. In your opinion, can rheumatoid arthritis lead to a physical disability related to work
758 (52.7%)Yes	758(52.7%)
232 (16.1%)No	232(16.1%)
449 (31.2%)I don’t know	449(31.2%)
6. In your opinion, can rheumatoid arthritis lead to deformation of the bones and joints in the body:
719 (50%)Yes	719(50%)
235 (16.3%)No	235(16.3%)
485 (33.7%)I don’t know	485(33.7%)
7. In your opinion, can rheumatoid arthritis be spread from person to person?
75 (5.2%)Yes	75(5.2%)
970 (67.4%)No	970(67.4%)
394 (27.4%)I don’t know	394(27.4%)
8. In your opinion, can rheumatoid arthritis be passed down genetically from parents:
Yes	717(49.8%)
No	285(19.8%)
I don’t know	437(30.4%)
9. In terms of gender, who is most likely to have rheumatoid arthritis:
Male	228(15.8%)
Female	774(53.8%)
Both sexes	437(30.4%)
10. Which of the following laboratory tests is most commonly used to evaluate this disease:
ESR	811(56.4%)
Random blood glucose	224(15.6%)
Blood Pressure	186(12.9%)
218 (15.1%)	serum cholesterol
11. Do you think RA is completely curable?
Yes	322(22.4%)
No	620(43.1%)
I don't know	497(34.5%)
12. In your opinion, does the disease requires lifelong treatment:
Yes	706(49.1%)
No	244(17%)
I don't know	489(34%)
13. Is physical therapy useful in this disease:
YES	516)35.9%)
NO	327(22.7%)
I don’t know	596(41.4%)

3-Rheumatoid Arthritis knowledge test results

The mean awareness of RA was 7.1 ± 4.3.

32.7% of the respondents had an excellent level of consciousness, 25.3% had an average level of consciousness, and 14% had a low level of consciousness, while 28% had a very low level of consciousness (Table-3),and (Figure-7).

Table-3

Rheumatoid Arthritis knowledge test results

greatest value	smallest value	mean (standard deviation)
14	0	7.1 (4.3)
Awareness about RA (Awareness Categories)
Excellent(> 70%)		470(32.7%)
Average (50%-70%)		364(25.3%)
Low(30%-<50%)		202(14%)
Weak (< 30%)		403(28%)

4-The relationship between knowledge about RA and demographic data

When examining the relationship between awareness of RA and the demographic factors of the participants, there was a statistically significant correlation between them as follows:

Most of the participants in the 18–24 age groups had an excellent awareness of the disease 48.5%.

The female gender had a medium level of awareness of 63.5% to excellent 63% compared to the male gender(p < 0.001). Most of the singles had an excellent degree of awareness 58.9% compared to the married 36%, and the divorced 14%,andwidows 1.1% (p < 0.001)

Most of non-educated participants had a low level of consciousness 81.4%, compared to those who studied in various university disciplines. (p < 0.001)

Most of the students had a significantly excellent awareness level( 48.9%) compared to the employed or unemployed (p < 0.001)

Very good economic status was significantly associated with an excellent level of awareness score of 47.4% (p < 0.001) (Table-4).

Table-4

The relationship between knowledge about RA and demographic data

Variables		Weak	Low	Average	Excellent	Chi- square	P- value
Age	< 18	83 (20.6%)	6 (3%)	14 (3.8%)	9 (1.9%)	379.440	0.000
	18–24	40 (9.9%)	41 (20.3%)	102 (28%)	228 (48.5%)
	25–34	39 (9.7%)	41 (20.3%)	75 (20.6%)	77 (16.4%)
	35–44	56 (13.9%)	40 (19.8%)	68 (18.7%)	83 (17.7%)
	45–54	79 (19.6%)	53 (26.3%)	80 (22%)	49 (10.4%)
	> 54	106 (26.3%)	21 (10.4%)	25 (6.9%)	24 (5.1%)
Gender	Male	209 (51.9%)	98 (48.5%)	133 (36.5%)	174 (37%)	28.462	0.000
Gender	Female	194 (48.1%)	104 (51.5%)	231 (63.5%)	296 (63%)	28.462	0.000
Marital status	married	148 (36.7%)	104 (51.5%)	180 (49.5%)	169 (36%)	114.472	0.000
	Single	161 (40%)	61 (30.2%)	145 (39.8%)	277 (58.9%)
	Divorced	66 (16.4%)	31 (15.3%)	31 (8.5%)	19 (14%)
	Widow/er	28 (6.9%)	6 (3%)	8 (2.2%)	5 (1.1%)
5-The relationship between the awareness scale about RA with knowledge questions of rheumatoid arthritis.

When studying the relationship between awareness scales and knowledge questions about RA, the results showed a significant relationship between them is as follows:

Those who knew that joint pain was a symptom of rheumatoid arthritis had an excellent level of awareness of 99.6%, compared to those who answered low blood sugar 0%, feeling sleepy 2%, high pressure 1%, and I don't know

0% (p < 0.001).

For those who knew that family history of rheumatoid disease is one of the risk factors for developing rheumatoid disease, excellent awareness level 90.4% compared to those who answered hyperglycemia 1.1%, hypertension 1.3%, family history of diabetes in the parents 0.4%, and i don't know 6.4% (p < 0.001).

Those who knew that rheumatoid arthritis does not only affect the joints or bones in the body had an excellent level of awareness77.9%, compared to those who answered yes 17.9%, or don't know 4.3%. (p < 0.001).

Those who knew that rheumatoid arthritis can lead to a physical disability had an excellent level of awareness93.8%, compared to 5.1% who answered no, and i don't know 1.1% (p < 0.001).

Those who knew that rheumatoid arthritis can lead to deformation of the bones and joints in the body had an excellent of awareness 91.1%, compared to those who answered no 6.4%, and don't know 2.6% (p < 0.001).

Those who knew that rheumatoid arthritis could not spread from one person to another had an excellent degree of awareness95.7%, compared to 3.2% who answered yes, and I don't know 1.1% (p < 0.001).

Those who knew that genetic predisposition is found in RA had an excellent level of awareness 89.8%, compared to 6.2% who answered no, and don't know 4% (p < 0.001).

It was for those who knew that rheumatoid arthritis had more affect female gender had an excellent awareness score of 84.1%, compared to those who answered with the male sex 7%, or both sexes 8.3.% (p < 0.001).

For those who knew rheumatoid factor, and ESR were commonly used For disease assessment, had an excellent awareness score of 94%, compared to those who answered blood sugar 1.3%, blood pressure 0.2%, serum cholesterol 4.5% (p < 0.001).

Those who knew that RA was completely incurable had a level of excellent awareness 83.4%, compared to those who answered yes 10.6%, and don't know 6% (p < 0.001).

Those who knew that RA required lifelong treatment had an excellent awareness score of 91.5%, compared to those who answered no 5.1%, and i don't know 3.4% (p < 0.001).

Those who knew that physical therapy is useful in this disease had an excellent degree of awareness 61.7%, compared to those who answered no 24.3%, and don't know 14% (p < 0.00)(Table-5)

Table-5

The relationship between the awareness scale about RA with knowledge questions of rheumatoid arthritis.

		Excellent	Average	Low	Weak	Chi- square	P- value
Do you know what rheumatoid disease is?	Yes, well aware of it	212 45.1%	27 7.4%	10 %5	0 %0	21.7	0.09
	Yes, sort of	253 53.8%	297 81.6%	160 79.2%	144 35.7%
	No	5 %1.1	40 11%	32 %15.8	259 %64.3
Which of the following is a symptom of rheumatoid arthritis?	Low blood glucose	0 (0%)	0 (0%)	5 (2.5%)	6 (1.5%)	744.1	0.00
	Joint pain	468 (99.6%)	354 (97.3%)	171 (84.7%)	130 (32.3%)
	Drowsiness	1 (0.2%)	1 (0.3%)	6 (3%)	10 (2.5%)
	High blood pressure	0 (0%)	2 (0.5%)	6 (3%)	17 (4.2%)
	I don't know	1 (0.2%)	7 (1.9%)	14 (6.9%)	240 (59.6%)
Which of the following is a risk factor for RA:	Hypertension	5 (1.1%)	23 (6.3%)	18 (8.9%)	20 (5%)	924.9	0.00
	high blood glucose	6 (1.3%)	17 (4.7%)	22 (10.9%)	8 (2%)
	Family history of diabetes in the parents	4 (0.4%)	32 (8.8%)	20 (9.9%)	10 (2.5%)
	Family history of rheumatoid arthritis	425 (90.4%)	130 (35.7%)	22 (10.9%)	5 (1.2%)
	I don't know	30 (6.4%)	162 (44.5%)	120 (59.4%)	360 (89.3%)
In your opinion, does RA only affect the joints or bones in the body:	yes	84 (17.9%)	150 (41.2%)	107 (53%)	52 (12.9%)	947.6	0.00
	no	366 (77.9%)	151 (41.5%)	48 (23.8%)	5 (1.2%)
	I don't know	20 (4.3%)	63 (17.3%)	47 (23.3%)	346 (85.9%)
In your opinion, can rheumatoid arthritis lead to a physical disability related to work	yes	441 (93.8%)	223 (61.3%)	75 (37.1%)	19 (4.7%)	1019	0.00
	no	24 (5.1%)	85 (23.4%)	82 (40.6%)	41 (10.2%)
	I don't know	5 (1.1%)	56 (15.4%)	45 (22.3%)	343 (85.1%)
In your opinion, can rheumatoid arthritis lead to deformation of the bones and joints in the body?	yes	428 (91.1%)	214 (58.8%)	64 (31.7%)	13 (3.2%)	955.7	0.00
	no	30 (6.4%)	88 (24.2%)	75 (37.1%)	42 (10.4%)
	I don't know	12 (2.6%)	62 (17%)	31 (8.5%)	348 (86.4%)
Do you think rheumatoid arthritis can spread from person to person?	yes	15 (3.2%)	31 (8.5%)	21 (10.4%)	8 (2%)	887.6	0.00
	no	450 (95.7%)	309 (84.9%)	147 (72.8%)	64 (15.9%)
	I don't know	5 (1.1%)	24 (6.6%)	34 (16.8%)	331 (82.1%)
Do you think rheumatoid arthritis can be passed on from parents?	yes	422 (89.8%)	197 (54.1%)	75 (37.1%)	23 (5.7%)	1015.4	0.000
	no	29 (6.2%)	112 (30.8%)	100 (49.5%)	44 (10.9%)
	I don't know	19 (4%)	55 (15.1%)	27 (13.4%)	336 (83.4%)
In terms of gender, who is most likely to have rheumatoid arthritis?	male	33 (7%)	67 (18.4%)	79 (19.6%)	228 (15.8%)	389.8	0.00
	female	398 (84.1%)	201 (55.2%)	86 (21.3%)	774 (53.8%)	389.8
	Both sexes are equal in terms of suffering	39 (8.3%)	96 (26.4%)	238 (59.1%)	437 (30.4%)
Which of the following laboratory tests is most commonly used to evaluate disease?	ESR (erythrocyte sedimentation rate)	442 (94%)	237 (65.1%)	95 (47%)	37 (9.2%)	691.5	0.00
	random blood sugar	6 (1.3%)	43 (11.8%)	60 (29.7%)	115 (28.5%)
	blood pressure	1 (0.2%)	35 (9.6%)	26 (12.9%)	124 (30.8%)
	serum cholesterol	21 (4.5%)	49 (13.5%)	21 (10.4%)	127 (31.5%)
Do you think rheumatoid arthritis is completely curable?	yes	50 (10.6%)	137 (37.6%)	100 (49.5%)	35 (8.7%)	943.2	0.00
	no	392 (83.4%)	159 (43.7%)	47 (23.3%)	22 (5.5%)	943.2	0.00
	I don't know	28 (6%)	68 (18.7%)	55 (27.2%)	346 (85.9%)
Do you think the disease requires lifelong treatment?	yes	430 (91.5%)	214 (58.8%)	55 (27.2%)	7 (1.7%)	1055.4	0.00
	no	24 (5.1%)	88 (24.2%)	92 (45.5%)	40 (9.9%)
	I don't know	16 (3.4%)	62 (17%)	55 (27.2%)	356 (88.3%)
Is physical therapy useful in this disease?	yes	290 (61.7%)	149 (40.9%)	57 (28.2%)	20 (5%)	595.5	0.00
	no	114 (24.3%)	115 (31.6%)	72 (35.6%)	26 (6.5%)
	I don't know	66 (14%)	100 (27.5%)	73 (36.1%)	357 (

Population awareness of RA symptoms is greatly important, as poor patients' awareness and ignorance of early symptoms of RA were important obstacles to seeking early medical care (22).

Most of the participants in the 18–24 age groups had an excellent awareness of the disease 48.5%, and this is in contractile with some studies which found that the elderly have better knowledge than the young population (23, 24). This indicates that younger people have more read medical issue, especially, there were 25.5% of our sample participants were young and were related to medical field, fore that, our study may in concordance with the previous studies, if we excluded those participants.

The female gender and singles had a significantly higher level of awareness compared to the male gender in our data, and we did not found any data in the published articles concerning this result, but it may due to the fact that the majority of women in our study are house wife, so they had time to read about medical conditions, like singles who also had more time, and less responsibilities than married ones.

Education level was associated positively with the knowledge in our study, as

most of non-educated participants had a low level of consciousness 81.4%, which is similarly found among other studies (24, 25, 26),although, Gulnur Tasci,et al. study(26) was about awareness of RA in RA patients.

Very good economic status was significantly associated with an excellent level of awareness, and this is compatible to other studies (23, 25, 27).

Most of the students had a significantly excellent awareness score of 48.9% compared to the employed or unemployed, and we did not found similar data in published articles.

In our study, 53.8% % of people were aware that women are more susceptible to RA orhter studies (23, 25).

The awareness of RA scale was 7.1 ± 4.3, and the awareness about RA symptoms was77.7%- of 99.6%, and this is higher than other studies, like the national rheumatoid arthritis society which found that 40% only aware of RA symptoms(23), and Simon et al study which found a limited understanding of RA symptoms(27), meanwhile,59.3% of our study participants knew about rheumatoid disease,49.8% knew that it is inherited, 67.4% knew that RA cannot spread from person to person, and 53.8% knew that the disease affects female sex more,meanwhile, 56.4% also knew that the erythrocyte sedimentation rate and rheumatic factor are the most laboratory assessments of the disease. Moreover, 43.1% knew that RA can be cured completely, 49.1% knew that the disease requires lifelong treatment, and 35.9% knew that physical therapy is useful, and these results are similar to the results of other studies(23–28).

There were some limitations in our study, when compared to the previous sheets ,as we missed asking questions like if RA affects younger more?, If the delay in diagnosis and treatment may lead to worse outcome of the disease?, and the types of medical treatment and surgery role?, and to whom RA patients should referred? .In addition to, we did not exclude the medical related field participants

This is the first study in Syria. In our study, the knowledge levels were not significantly high enough. Thus, to be able to increase the peoples’ awareness, more social and medical awareness and precautions should be taken.

Conflict of interest

The authors declare that there is no conflict of interest regarding the publication of this article.

Funding

None

Ethics: This study was approved by the Institutional Review Board of Syrian Private University and the Ethics Committee of Al-Moussat University Hospital.

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Rheumatoid Arthritis in Syria: Knowledge and Awareness among the General Population

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Abstract

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Background

Methods

Statical analysis

Results

1-Demographic data

2- Knowledge about Rheumatoid Arthritis

3-Rheumatoid Arthritis knowledge test results

4-The relationship between knowledge about RA and demographic data

Discussion

Conclusion

Declarations

References

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