Author(s)

William Buwembo^1*, Ian Guyton Munabi^1*, Mark Kaddumukasa², Haruna Kiryowa¹, Ethel Nankya³, William Evan Johnson³, Emmy Okello², Nelson Sewankambo²

¹Department of Human Anatomy, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda.
²Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
³Division of Computational Biomedicine, Boston University School of Medicine, Boston University, Boston, MA, USA.

Background: This review identified papers that described periodontitis and rheumatoid arthritis in sub-Saharan Africa. Only English language publications from January 2010 to December 2017 describing original research in sub-Saharan Africa on the association between periodontitis and rheumatoid arthritis were considered for this study. Methods: Published databases: Pub-Med, Science direct and Google scholar, were searched using terms “periodontitis”, “rheumatoid arthritis” and “Sub-Saharan Africa” to generate a set of putative studies. Articles with data on both rheumatoid arthritis and periodontitis compared to controls were selected. Studies on the association of periodontitis with cardiovascular disease, arthritis or rheumatoid arthritis alone were excluded. Data were extracted, critically appraised, and analyzed using a random-effect Mantel-Haenszel meta-analysis on plaque index, gingival index, pocket depth and clinical attachment loss. Results: Three publications were selected for the systematic review and 2 for the meta-analysis. Two studies were from Sudan, and one was from Burina Faso. There was a significant increase in pocket depth (mean difference: 0.31; 95% CI: 0.21, 0.41; N = 274; (p ≤ 0.001)) and clinical attachment loss (mean difference: 0.47; 95% CI: 0.22, 0.75; N = 274; (p ≤ 0.001)) in participants with rheumatoid arthritis compared to normal controls. Conclusion: Findings from these combined studies show a significant relationship between periodontal disease and rheumatoid arthritis with increased periodontal pocket depth and clinical attachment loss. They also highlight the need for additional work especially in the area of associating rheumatoid arthritis with P. gingivalis, the oral microbiome and treating periodontal diseases to help in the management of rheumatoid arthritis.

Periodontitis, Rheumatoid Arthritis, Sub-Saharan Africa

Buwembo, W. , Munabi, I. , Kaddumukasa, M. , Kiryowa, H. , Nankya, E. , Johnson, W. , Okello, E. and Sewankambo, N. (2019) Periodontitis and Rheumatoid Arthritis in Sub-Saharan Africa, Gaps and Way Forward: A Systematic Review and Meta-Analysis. Open Journal of Stomatology, 9, 215-226. doi: 10.4236/ojst.2019.910023.