Malondialdehyde-Superoxide Dismutase Redox Imbalance as an Early Biological Risk Indicator in Young Adult Smokers.

Rheumatoid arthritis (RA) is one of the most common chronic autoimmune inflammatory diseases, affecting approximately 1% of the global population. However, its prevalence varies significantly across geographic regions, ethnic groups, and socioeconomic settings. While prevalence is estimated to be around 1% in North America, lower rates of approximately 0.2%–0.3% have been reported in populations such as China, Japan, north-west Greece, rural Africa, and Egypt, suggesting the influence of genetic, environmental, and demographic factors on disease distribution. Differences are also observed in public awareness, healthcare-seeking behaviors, and disease-related knowledge across populations (). RA is characterized by persistent synovial inflammation leading to joint destruction and functional impairment if left untreated. The disease commonly presents with symmetrical joint pain and prolonged morning stiffness involving the small joints of the hands and feet, with possible progression to larger joints and extra-articular manifestations affecting organs such as the lungs, heart, eyes, and nervous system. The development of RA involves complex interactions between genetic susceptibility and environmental triggers. Diagnosis relies on clinical assessment supported by imaging techniques, including X-ray, magnetic resonance imaging (MRI), and ultrasound, alongside laboratory investigations such as rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) antibodies, and inflammatory markers including C-reactive protein (CRP) (). Despite its prevalence and significant impact on quality of life, awareness and understanding of RA among the general public remain limited. Previous studies have demonstrated widespread misconceptions regarding disease symptoms, risk factors, systemic complications, and treatment. A study from Netherlands found insufficient public knowledge of rheumatic diseases, although participants expressed interest in receiving additional information (). Similarly, research from Iraq reported inadequate RA knowledge regardless of educational background, indicating that formal education alone may not address disease awareness gaps (). In Saudi Arabia, a considerable proportion of participants incorrectly perceived RA as a condition limited to the joints, reflecting poor recognition of its systemic nature (). Other studies have shown that RA symptoms are often underestimated compared with other chronic diseases, potentially delaying healthcare-seeking behavior and diagnosis (). Surveys from the UK and China have further identified gaps in awareness of RA epidemiology, disease progression, and management approaches, emphasizing the importance of patient education and improved communication between healthcare providers and communities (, ). Furthermore, a survey of 1,050 Arab patients identified significant deficiencies in knowledge about rheumatic diseases and concerns about treatment complications, emphasizing the need for improved patient education and physician-patient communication ().