Objective To examine the prevalence and risk factors of rheumatoid arthritis (RA) among rural residents aged of 20 – 79 years living in Qiannan prefecture of Guizhou province (Qiannan) and to provide references for developing relevant interventions.

Methods We carried out a questionnaire survey, routine physical check up, imaging examination and laboratory tests among 118 587 residents aged 20 – 79 years selected with random cluster sampling in rural Qiannan between January 2017 and October 2018. We used SAS 9. 1 in data analyses.

Results Among the participants, totally 1 097 RA cases were diagnosed; the crude and standardized RA prevalence rate was 0.925% and 0.917%. The results of multivariate unconditioned logistic regression revealed following risk factors of RA: female (odds ratio OR = 5.512, 95% confidence interval 95% CI: 1.348 – 6.129), aged 40 – 79 years (compared to the aged 20 – 29 years: OR = 1.976 – 5.172), Shui nationality (OR = 4.812, 95% CI: 1.215 – 5.786), Maonan nationality (OR = 2.896, 95% CI: 1.223 – 4.195), Miao nationality (OR = 1.886, 95% CI: 1.136 – 3.603), smoking (OR = 3.108, 95% CI: 1.165 – 4.382), preference for light diet (OR = 3.072, 95% CI: 1.207 – 4.50), depression (OR = 2.798, 95% CI: 1.164 – 3.681), living in a damp environment (OR = 4.491, 95% CI: 1.275 – 5.765), living in a slate house (OR = 3.867, 95% CI: 1.218 – 5.963), engaged in a work with the labor intensity of grade Ⅲ (OR = 2.817, 95% CI: 1.133 – 3.132) or grade Ⅳ (OR = 3.927, 95% CI: 1.226 – 4.929), family RA history (OR = 3.732, 95% CI: 1.137 – 5.214), tuberculosis history (OR = 2.084, 95% CI: 1.212 – 3.479), mumps history (OR = 2.014, 95% CI: 1.206 – 3.335), injury history (OR = 1.997, 95% CI: 1.136 – 3.421), with a menarche age of ≥ 17 years old (OR = 2.342, 95% CI: 1.215 – 4.667); the results also indicated following protective factors against RA: Buyi nationality (OR = 0.397, 95% CI: 0.332 – 0.995), other nationality (OR = 0.678, 95% CI: 0.462 – 0.997), and tea drinking (OR = 0.487, 95% CI: 0.125 – 0.765).

Conclusion The prevalence rate of rheumatoid arthritis is relatively high and interventions on risk factors of the disease needs to be conducted among 20 – 79 years old residents in rural regions of Qiannan prefecture of Guizhou province.