Rheumatic Diseases And Rheumatology Service Capacity In The Samarkand Region Of Uzbekistan: A Regional Analysis Of Routine Health Data, 2019–2024

Abstract

Aim. To describe the registered burden of rheumatic diseases and the capacity of specialist rheumatology services in the Samarkand region of Uzbekistan — a Central Asian setting for which no data have previously been reported in the international literature.

Methods. Retrospective analysis of routine health-service data for the Samarkand region (resident population 4,208,509 in 2024). Registered cases of 15 rheumatic conditions for 2019–2023 were extracted from the annual reports of the regional chief rheumatologist and from statutory statistical reporting forms of 34 primary care facilities (20 family polyclinics in Samarkand city and 14 district multiprofile central polyclinics). Workforce data (established posts, occupied posts, individual physicians, qualification category, district distribution) and service-utilisation data (dispensary registration, inpatient admissions) were analysed for 2022–2024. Crude registered prevalence was expressed per 100,000 resident population. Analyses were descriptive.

Results. Registered cases of rheumatic disease rose from 11,535 in 2019 to 13,828 in 2023 (+19.9%), with a transient fall in 2020 (11,296) coinciding with the COVID-19 pandemic. Crude registered prevalence in 2023 was 334.5 per 100,000 total population. Three conditions accounted for 77.2% of all registered cases in 2023: osteoarthritis (29.9%), rheumatoid arthritis (27.0%) and chronic rheumatic heart disease (20.3%). The largest relative increases were seen for osteoporosis (+45.3%), gout (+36.7%) and rheumatoid arthritis (+35.5%), whereas acute (−27.8%) and recurrent (−28.6%) rheumatic fever declined. In 2024 the region had 21.0 established rheumatology posts, 19.0 of them occupied, and 23 individual rheumatologists — 0.55 physicians per 100,000 total population and 0.87 per 100,000 adults; 11 of 23 physicians (47.8%) held no qualification category, and one district of 141,851 inhabitants had no established rheumatology post. Between 2022 and 2024, patients under dispensary follow-up increased by 55.1% (5,966 to 9,253) and rheumatology inpatient admissions by 61.0% (1,916 to 3,084).

Conclusion. In this Central Asian region the registered burden of rheumatic disease is rising and service utilisation is expanding rapidly, while specialist capacity remains 1.5- to 4-fold below levels reported for Europe, the USA and neighbouring CIS countries, with marked intra-regional inequity. These are the first published data on rheumatology service capacity from Central Asia and support task-sharing with primary care, structured referral pathways and targeted workforce expansion.