The Time Lag Between the Onset of Symptoms and Diagnosis of Ankylosing Spondylitis in Sulaymaniyah Province, Iraq

Ankylosing spondylitis (AS) is a chronic, progressive, and disabling disease among rheumatological diseases. Current study aimed to investigate the Time lag between the onset of symptoms and final diagnosis of AS, and also identify the factors that contribute to that delay in Sulaymaniyah province. In this cross-sectional study, 104 (AS) patients who satisfied the modified New York 1984 criteria were enlisted. The time lag was defined as the diagnosis delay (DD) between the appearance of the first symptoms and the correct diagnosis of AS. Spearman correlation analysis was used to detect correlations between variables. The higher percentage of variables with DD ≥ 6 years were urban 32 (74.4%), housewife 15(34.9%), had no family history 42 (97.7%), with high diploma 33 (76.7%), and positive HLAB27 31 (72.1%), the first specialist consulted orthopedics 21(48.8%) then GP 6 (14.9). Moreover, the higher percentage of variables with DD < 6 years were diagnosis years between 2000 to 2020, rural 55 (90.2), 39 (63.9%) respectively, higher education 47 (77%), employee and worker 22 (36.1%), positive family history 44 (72.1%), positive human leukocyte antigen (HLAB27-61) (100%), inflammatory back pain 47 (77%), rheumatologist 29 (47.5%). The average year’s DD is 6.48. A statistically significant positive correlation was detected between the DD and age, age at diagnosis but, a negative correlation was found between the DD time and, age at symptom onset. The Time lag between the onset of symptoms of AS and the final diagnosis in Sulaymaniyah was 6.48 years. (HLA-B27), age, age at diagnosis, education level, occupation, 1st specialist, 1st symptom at onset of disease and family history are the factors that affect delayed diagnosis in Sulaymaniyah patients with AS.