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CS I, JO M, P K, K M, M M, EK G, A S,, Owino B WMOGOWT. "Knowledge, Attitude and Practices of Health Care Workers on Corticosteroid Adverse Drug Events in Rheumatologic, Respiratory and Dermatologic Clinics in a Teaching Hospital in Nairobi.". In: Oral Abstract 7th African League of Associations for Rheumatology (AFLAR) Congress. . Lagos, Nigeria. ; 2015.
Gitahi N, Kiarie J, Mecha J, Ilovi S. "Implementation of HIV discordant couple care and treatment program in a Kenyan referral hospital.". In: 8th IAS Conference on Pathogenesis, Treatment and Prevention, Vancouver, . Canada ; 2015.
Ilovi CS, Mecha JO, Wambui M, Njagi LN, Kamau NG. "HIV in the Elderly: Are Outcomes Comparable to Younger Patients? Perspectives from a Kenyan Tertiary HIV Clini.". In: Oral Abstract 1st Annual HIV Clinician’s Conference, .; 2015.
Ilovi CS, Mutisya I, Njuguna E, Njagi LN, Kamau NG, Mutai K, Muiruri P, Mecha JO. "Treatment Outcomes after Switch to Second-line Protease Inhibitor Based ART in a Kenyan National Referral Facility.". In: Oral Abstract 1st Annual HIV Clinician’s Conference. Nairobi, Kenya.; 2015.
JO M, R W, J W, R O, C K, J M, E M. "Establishing adolescent friendly services and use of adolescent package of care to improve outcome of ALHIV at a rural health center.". In: 10th Annual HIV Prevention, Care & Treatment Consultative Forum, . Nairobi, Kenya; 2015.
Mecha J, Gitahi-Kamau N, Ilovi S, L. Njagi, Njuguna E, Mutai K, Katei I, Inwani I. "Optimising adolescent HIV care in a large Kenyan care and treatment centre.". In: IAS Conference on Pathogenesis, Treatment and Prevention, Vancouver, . Canada; 2015.
"Jared Mecha Jared Mecha Assessment of pulmonary function in rheumatoid arthritis patients attending Rheumatology Clinics in Nairobi." African Journal of Rheumatology. 2013;1. AbstractWebsite

Background: Pulmonary involvement is a frequent and among the most severe extra-articular manifestations of Rheumatoid Arthritis (RA) ranking as the second cause of mortality in this patient population. Rheumatoid arthritis can a ect the lung parenchyma, airways and pleura. Pulmonary complications are directly responsible for 10-20% of all mortality in RA patients. Spirometry is becoming increasingly available in Kenya and could be used in peripheral areas to screen and monitor for pulmonary function abnormalities in well characterized patient populations such as those with RA. Abnormalities detected by pulmonary function tests may precede symptoms by years and lead to early diagnosis of pulmonary fibrosis in rheumatoid arthritis and
hence intervention.
Objective: To determine the prevalence of pulmonary function abnormalities in rheumatoid arthritis patients attending Rheumatology Clinics in Nairobi.
Design: Cross sectional descriptive study.
Setting: Nairobi Rheumatology Clinics in Kenyatta National Hospital, Aga Khan University Hospital and Mater Hospital. Methods: Rheumatoid arthritis patients aged 13 to 65 years who fulfilled the study inclusion criteria were recruited. Sociodemographic characterictics and respiratory symptoms were assessed using Lung Tissue Research Consortium questionnaire (LTRC) and RA disease activity was established by Disease Activity Score (DAS28). Pulmonary function tests were then done using Spirolab 111 according to the American Thoracic Society recommendations.
Results: One hundred and sixty six RA patients were recruited; the male to female ratio was 1:9.3, with a median age of 47 years. The overall six month prevalence of pulmonary function abnormalities was 38.5% as measured by Spirometry and all our patients did not carry any prior pulmonary disease diagnosis. The predominant ventilatory defect was obstructive pattern at 20.4%, followed by restrictive pattern at 16.8% and least common being a mixed picture at 1.2%. Factors that were shown
to be independently associated with pulmonary function abnormalities were age and RA disease activity. Respiratory
symptoms that were predictive of PFTs abnormalities were cough, increased frequency of chest colds and illnesses
and phlegm.
Conclusion: High prevalence of pulmonary function abnormalities was observed. Respiratory symptoms, older age and ongoing disease activity can identify patients in greatest need of further pulmonary evaluation.

Key words : Rheumatoid Arthritis, Pulmonary function test, Nairobi Rheumatology Clinics


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