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Tackling rheumatoid arthritis in Africa

- Wits University

Research could not, and should not be done in isolation.

That is the strong belief of Professor Mohammed Tikly, Principal Specialist Physician and Academic Head of the Division of Rheumatology in the Wits Faculty of Health Sciences.

“It is all about collaboration,” says Tikly, who since 1997 has trained 14 specialist rheumatologists at the hospital and supervised several Masters and PhD students to completion. Tikly, who started out as an intern at the Chris Hani Baragwanath Academic Hospital 35 years ago, saw the research potential at the hospital after he returned from the University of Edinburgh in 1990 and he immediately started up the Rheumatology Division.

“One of the things that struck me was that there is so much research potential at the hospital,” he says. “We produce very good clinicians but not enough clinical researchers.”

Tikly immediately started researching Rheumatoid Arthritis in African people - both clinically and with the support of the Human Sciences Research Council, the social impacts of the disease.

“The challenges for patients with Rheumatoid Arthritis in Africa are somewhat different to those of patients in industrial countries,” he says. “Patients here have many more difficulties in terms of transport, public transport, amenities like housing, running water, toilets and coping with pain.”

But while Tikly sees himself primarily as a physician with a strong interest in research, he has over the years become one of the leading researchers in his fields, with his publications being cited all over the world.

His mentorship of others, however, is what excites him most. As a true leader, Tikly has the ability to identify gaps in research areas and to inspire other academics to conduct great research.

In one specific case, Tikly brought together specialists in immunology, genetics and clinicians from the University of Pretoria and Wits, as well as researchers from universities from the United States to study various areas of Rheumatoid Arthritis.

The collaborations resulted in 19 publications on various aspects of clinical outcomes of treatment, genetic risk factors by studying the entire genome and using accelerometry as a novel method to assess physical disability and the habitual physical activity in rheumatoid arthritis.

“Out of that study, we have produced five PhDs since the start of the collaboration,” says Tikly.

“When we open up to other people, everybody benefits. You have to surround yourself with smart people – that’s what makes you smart.”

The study on the relation of the disease to the habitual physical activity of patients was published in the leading journal, Rheumatology (Oxford).

“We were probably the first group to have shown this,” says Tikly.

Subsequent research also showed for the first time in Africa that the aggressive treatment of Rheumatoid Arthritis is more effective in reversing the inflammation and disability caused by the disease.

“We are actually using that aggressive treatment now in the clinic,” concludes Tikly.

“The patient is the centre of our research. It has to somehow impact on healthcare. We have to be relevant to the society within which we work.