Autoimmune diseases are characterized by the immune system's abnormal response against the body's own tissues, leading to inflammation and damage. Understanding the prevalence, risk factors, and impact of autoimmune diseases among any population is essential for improving awareness and healthcare strategies. Rheumatoid diseases fall under many autoimmune diseases, such as rheumatoid arthritis, multiple sclerosis, [1], and systemic lupus erythematosus (SLE), which are disorders where the body's immune system attacks its own healthy tissues and organs. SLE is a chronic inflammatory autoimmune disease, with significant prevalence among females of reproductive age [2]. Environmental, immunological, and hormonal variables lead to the clinical development of SLE, which can affect any organ, including cardiovascular, respiratory, hematologic, renal, neurological, and skin organs, however with psychiatric effects. SLE is a classic autoimmune condition with an estimated frequency of 6.5-178.0 per 100,000 people, having an annual incidence between 0.3 and 23.7 per 100,000 people [3]. Management of SLE slows down the disease's development and prevents new sequelae.

Another condition is Sjögren syndrome, which is a chronic systemic autoimmune disorder characterized by lymphocytic infiltration of exocrine glands and remarkable B-cell hyperactivity. It is nine times more common among women than men and has a prevalence range from 0.1% to 4.8% [1]. Secondary Sjögren syndrome is associated with an established connective tissue disease, and the primary etiopathogenetic events are not known. The current hypothesis is that an interplay between environmental factors (e.g., viruses, stress, hormones) and the patient's genetic background can lead to inflammatory responses against epithelial tissues [4]

Rheumatoid arthritis (RA) is associated with joint erosion, functional loss, and reduced overall quality of life. The global prevalence of RA has been estimated to range from 0.24 to 1%, although rates vary by region and country. Factors such as age, ethnicity, smoking history, and urban living appear to affect the incidence of RA. Women are consistently found to be at higher risk of RA than men, and the discrepancy appears to be related to hormonal factors [1] .Ankylosing spondylitis (AS) is a disabling chronic arthritis characterized by systemic inflammation leading to fusion of the axial skeleton. Estimates of the incidence and prevalence of AS range from 0.05 to 1.4/10,000 person-years and from 0.1% to 1.4%, respectively. Treatment initiation in the earlier stages of disease associates with better clinical response and increased likelihood of remission. [5]

 However, diagnosis remains a challenge in the AS disease spectrum due to the lack of pathognomonic symptoms and signs of disease, leading to significant delays between the first symptoms of inflammatory back pain (IBP) and the diagnosis being made [6]. Hospital-based studies may miss earlier reported symptoms of IBP that are often first presented in primary care, and studies of diagnostic delay tend not to distinguish AS from other concepts. Efforts have been made to improve the recognition and diagnosis of AS and MRI becoming an important tool for identifying inflammatory lesions before sacroiliitis is radiographically detectable [7].

Importance of the study 

This study aims to investigate autoimmune diseases among students of Al Noor University College in Mosul, Iraq.  Because Autoimmune diseases are a major public health concern, affecting millions of people worldwide.  Moreover The prevalence of autoimmune diseases is increasing, and they are now consideration the second leading cause of death in women aged 15-44 years. In addition There is limited data on the prevalence and risk factors for autoimmune diseases in Iraq. 

This study will provide valuable information on the epidemiology of autoimmune diseases in Iraq and help identify potential risk factors for these disease. 

The objectives of this study are to: 

1.Determine the prevalence of autoimmune diseases among students of Al Noor University College. 

2.to Identify the most common types of autoimmune diseases among students. 

3.and to Assess the factors affecting the development of autoimmune diseases among students.

A questions is prepared and distributed to whom participating in this study questions included important point .

1.The prevalence of autoimmune diseases.

2.Most common types of autoimmune diseases 

3.Factors affecting the development of autoimmune diseases among students? 

This study was  conducted using a cross-sectional survey. Other point included to the 

The questionnaire will include questions on the following: 

• Demographics (age, sex, etc.) , this ages between 20-70 years old 
• History of autoimmune diseases) 
• Family history of autoimmune diseases 
• Lifestyle factors (diet, exercise, smoking, etc.) 

Study design: 

A Randomized controlled trial study. 

Time of study: 

 Started from  15/1/2024  to 10/3/2024 

Study setting: 

The current study was conducted in Al-Noor University College 

The sample of the study consist: 

500 samples 

Exclusion criteria: 

Normal cases weren’t excluded 

Data collection tools: 

The data were collected by the researcher through: 

People participated in this study were subjected interviews and data collected as to induced 

The researcher conducted interviews with the participants, 

The survey, which included 500 students, revealed an infection rate of 9.8%, accounting for 49 patients suffering from various autoimmune rheumatic diseases. (Tables 1). The distribution of infection rates by diseases is as follows: Rheumatoid arthritis (RA) (3.4%), Systemic lupus erythematosus (SLE) (3.4%), Sjögren’s syndrome (1%), Ankylosing spondylitis (1%), Psoriatic arthritis (1%), and Bechet's disease (0%).(Table 2)

Table 1: Distribution of occurrence by Gender

Table 2 : occurrence  Rates between sexes for each

Table 3 : Impact of occurrence on social Status and psychological effects on the patient

Table 4: Presence of genetic factors' Impact on disease occurrence

Table 2 shows the incidence of thematic diseases in different sexes in this study, RA and systemics lupus erythematosus had higher values - (3-4%) among others. While other RA had1%. (See Table2)

Table 3 showed the impact of the occurrence of R disease on social and psychological effect of the patient in this study. RA showed the highest value (18.18%.) among others. systemics lupus erythematosus had 3%. whilst 

Table 4 showed the role of genetic factors is important of the disease in this study. RA was the highest role -45.45% and the Bechet's disuse was the lower. (See Tabl4)

 In the present study an effort was done to investigate of the incidence of rheumatoid disease and the role of different factors on the occurrence in alnoor university population. A broad range of age groups and ethnicities are susceptible to autoimmune disorders, making them a global public health emergency. Finding out how common immunological illnesses amount of knowledge among Al-Nour University students. The recent showed that 9.8% of the participants had immune-rheumatic diseases.  This result were supported by previous investigators in field surveys of both urban and rural populations [8-10], Although our results were higher than the percentages recorded in few rural areas, which was reported as low as 1% [11]. This is because these communities have a poor cultural level, few people go to health units, the paperwork isn't accurate and full, and there aren't enough diagnostic tools for immunological disorders in rural regions [11]. In most rheumatic diseases, the results showed that females are more likely to suffer than males. This is due to hormonal stress in women, which is impacted by pregnancy, miscarriage, and childbirth. In males, other factors like environmental and psychological factors contribute to the higher suffering rates. These rates were considered as   normal and in agree with other investigator [12,13]. Rheumatoid arthritis had the greatest suffering incidence here at 3.4% and psoriatic arthritis had the lowest at 1% among many disorders studied. There were no male cases of Bechet's disease, which is one of the most rarest diseases among societies; the majority of the people studied were young; the disease mostly affects older people  and these are all normal rates and agree with other researchers who have studied this disease in different regions of the world and different section [14,15]. The effects of autoimmune illnesses on students are complex, and our findings clarify several key points. The extent to which students are knowledgeable of autoimmune disorders is one of the most striking findings from this study. Answers to questions about symptoms, risk factors, and therapeutic tactics lead to a possible deficiency in understanding these disorders. To encourage early identification and appropriate care of autoimmune disorders, it is crucial to raise awareness and educate the student population about these conditions. Furthermore, study should be done to know, how common autoimmune illnesses were among the students [16]. Investigators showed how much of an influence autoimmune disorders had on students' daily life; thus, they gathered information on self-reported diagnoses and symptoms. Investigators found that pupils' mental health suffered when they were sick at a young age, which reduced their energy and motivation [17]. As reported in this study, Rheumatoid arthritis had the greatest number of psychological effects. this may be a rather high number, but it does not imply Depending on one's unique characteristics, the remaining percentages have discernible impacts [18]. We found normal percentages ranging from 20% when we looked at the existence of hereditary variables; these numbers agree with those of many other studies [19]. To better address the needs of those affected, health care policy and resource allocation may be guided by the insights provided by the data about the burden of autoimmune illnesses among young. The highest negative impact on an individual’s life, especially on females, was reached systemic lupus erythematosus, disease in addition of genetic effects. [20,21]

Through this research, it becomes evident that there is a need for educational initiatives and health promotion campaigns within the university setting to enhance students' understanding of autoimmune diseases, their symptoms, risk factors, and management options. By empowering students with knowledge, they can become proactive in seeking medical attention when needed and adopting healthy lifestyle choices to manage their health effectively.

Furthermore, the study underscores the importance of early detection and intervention in autoimmune diseases to prevent complications and improve outcomes. Healthcare providers and university health services can play a crucial role in offering screening programs, providing access to resources, and offering support services for students living with autoimmune conditions.

Moving forward, future research endeavors can build upon the findings of this study to explore additional factors influencing the prevalence and impact of autoimmune diseases among university students. Longitudinal studies tracking the health status of students over time and qualitative research to delve deeper into the lived experiences of those affected by autoimmune diseases can provide valuable insights for healthcare planning and policy development.

Ultimately, by addressing the challenges posed by autoimmune diseases among university students, we can work towards creating a supportive environment that fosters their academic success, personal growth, and overall well-being. Through collaborative efforts between academia, healthcare professionals, and policymakers, we can strive to mitigate the burden of autoimmune diseases and improve the quality of life for all individuals within the university community.  

The authors declare that they have no conflict of interest

No funding sources

The study was approved by the AL Noor University College Mosul, Iraq.

1. Almoallim et al.; "Rheumatoid arthritis in Saudi Arabia" 35 (2014) Pp1442–54.

2. Kiriakidou et al.; "Systemic lupus erythematosus" 172.1 (2020) PpITC81–96.

3. Bae et al.; "Trend of prevalence and incidence of systemic lupus erythematosus in South Korea, 2005 to 2015: a nationwide population-based study" 35.1 (2020) Pp652–61.

4. Baer et al.; "Update on Sjögren syndrome and other causes of sicca in older adults" 44.1 (2018) Pp419–36, https://doi.org/10.1016/j.rdc.2018.03.002.

5. Martindale et al.; "The impact of ankylosing spondylitis/axial spondyloarthritis on work productivity" 29.1 (2015) Pp512–23.

6. Feldtkeller et al.; "Age at disease onset and diagnosis delay in HLA-B27 negative vs. positive patients with ankylosing spondylitis" 23.1 (2003) Pp61–6.

7. Keat et al.; "BSR guidelines for prescribing TNF-blockers in adults with ankylosing spondylitis" 44.1 (2005) Pp939–47.

8. Carter et al.; "The global burden of SLE: prevalence, health disparities and socioeconomic impact" 12.1 (2016) Pp605–20.

9. Barber et al.; "Global epidemiology of systemic lupus erythematosus" 17.1 (2021) Pp515–32.

10. Brito-Zerón et al.; "Epidemiological profile and north–south gradient driving baseline systemic involvement of primary Sjögren’s syndrome" 59.1 (2020) Pp2350–9, https://doi.org/10.1093/rheumatology/kez578.

11. Almoallim et al.; "Achieving comprehensive remission or low disease activity in rheumatoid patients and its impact on workability - Saudi Rheumatoid Arthritis Registry" 11.1 (2019) Pp89–95.

12. Yen et al.; "Lupus—An unrecognized leading cause of death in young females: a population-based study using nationwide death certificates, 2000-2015" 70.1 (2018) Pp1251–5.

13. Tan et al.; "Frequency of systemic lupus erythematosus was decreasing among hospitalized patients from 2013 to 2017 in a national database in China" 8.1 (2021) Pp648727.

14. Davatchi et al.; "Behcet's disease: epidemiology, clinical manifestations, and diagnosis" 13.1 (2017) Pp57-65, https://doi.org/10.1080/1744666X.2016.1205486.

15. Kaur et al.; "The current and novel imaging modalities for ocular vasculitis in Behcet's disease: A review" 16.9 (2024) Pp e69528, https://doi.org/10.7759/cureus.69528.

16. Badsha et al.; "Reasons for discontinuation of biological drug and targeted synthetic drugs among patients with inflammatory arthritis in the United Arab Emirates (UAE)" 78.1 (2019) Pp1642–3.

17. Leong et al.; "The prevalence and incidence of systemic lupus erythematosus in Taiwan: a nationwide population-based study" 11.1 (2021) Pp5631.

18. Durcan et al.; "Management strategies and future directions for systemic lupus erythematosus in adults" 393.1 (2019) Pp2332–43.

19. Alamanos et al.; "Epidemiology of systemic lupus erythematosus in northwest Greece 1982-2001" 30.1 (2003) Pp731–5.

20. Aringer et al.; "2019 European League against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus" 71.1 (2019) Pp1400–12.

21. Schwarting et al.; "The burden of systemic lupus erythematosus in Germany: incidence, prevalence, and healthcare resource utilization" 8.1 (2021) Pp375–93.