title: Rheumatoid arthritis in Latin America: the importance of an early diagnosis.
abstract: The generalization of the early rheumatoid arthritis (ERA) concept and the existence of a window of therapeutic opportunity-a time span in which the institution of a proper therapeutic method for the disease would determine clinical improvement-have set the notion that early diagnosis and treatment may modify the course of the disease. Although in several regions of the world, especially in North America and Europe, since the year 2000, a significant reduction in diagnostic delay was observed in cohorts of patients with rheumatoid arthritis (RA), probably reflecting a stronger awareness of the importance of early diagnosis, this is not a reality in Latin America (LA). LA is a region of great economic inequality, with disparities in access to the public healthcare system and limited access to private medicine, being widely difficult to obtain a specialized medical evaluation in both scenarios. This paper aims to briefly review the main difficulties in the management of ERA in LA, based on the review of the literature, on the evaluation of a survey conducted among 214 rheumatologists of LA, members of Pan-American League of Associations for Rheumatology (PANLAR) and the experience of the authors. The paper also aims to propose solutions to the difficulties in managing ERA in LA.
authors.affiliation: Serviço de Reumatologia, Hospital Universitário de Brasília, Universidade de Brasília (UnB), Campus Universitário Darcy Ribeiro, Brasília, Distrito Federal, 70910900, Brazil. liciamhmota@gmail.com.
authors.forename: Licia Maria Henrique
authors.initials: LM
authors.lastname: da Mota
authors.affiliation: Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Ramiro Barcelos 2350, Porto Alegre, Rio Grande do Sul, CEP 90035-903, Brazil.
authors.forename: Claiton Viegas
authors.initials: CV
authors.lastname: Brenol
authors.affiliation: Rheumatologist, Rheumatology Division, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Ramiro Barcelos 2350, Porto Alegre, CEP 90035-903, Rio Grande do Sul, Brazil.
authors.forename: Penelope
authors.initials: P
authors.lastname: Palominos
authors.affiliation: Universidade Estadual do Rio de Janeiro, Boulevard 28 de Setembro, 77 sala 333 - CEP 20551-030, Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Geraldo da Rocha Castelar
authors.initials: Gda R
authors.lastname: Pinheiro
mesh_terms: D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000453:epidemiology*; D057210:Delayed Diagnosis; D019468:Disease Management; D042241:Early Diagnosis; D018166:Health Care Reform; D006801:Humans; D007843:Latin America
keywords: Difficulties; Early; Inequality; Latin America; Rheumatoid arthritis; Solutions