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We believe there are several reasons for these challenges, including: (a) limited awareness of the disease manifestations and prevalence in the region among physicians; (b) the concept of nonradiographic axSpA, while accepted with some difficulty by the rheumatology community, may not be well understood by the referring primary care physicians; (c) access to, and training in magnetic resonance imaging varies greatly between countries in the North Africa and Middle East region, and this may have a large impact on early diagnosis; (d) country\u2010specific treatment guidelines are unavailable; and (e) economic and cultural factors influence patients\u2019 attempts to seek and continue treatment. In this review, we will discuss the prevalence of axSpA in North Africa and the Middle East, as well as the challenges to diagnose and treat patients in this region. As rheumatologists practicing in North Africa and the Middle East, we also provide suggestions to assist physicians, other healthcare professionals, and researchers in facilitating early, accurate diagnosis and treatment of axSpA.<\/jats:p>","DOI":"10.1111\/1756-185x.13961","type":"journal-article","created":{"date-parts":[[2020,9,22]],"date-time":"2020-09-22T08:11:53Z","timestamp":1600762313000},"page":"1574-1580","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["The treatment journey for patients with axial spondyloarthritis in North Africa and the Middle East: From diagnosis to management"],"prefix":"10.1111","volume":"23","author":[{"given":"Bassel","family":"El Zorkany","sequence":"first","affiliation":[{"name":"Rheumatology Department Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaser 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