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RHEUMATIC DISORDERS IN SUB-SAHARAN AFRICA
Abstract
Objective: To review prevalence of rheumatic disorders in Sub-saharan Africa and in the
context of current medical practice in the region assess the need for service and educational
provision.
Data sources: Medline, (English, French). Pre-medline literature review from the 1950’s
(Current contents). Various conference reports including attendance at all three AFLAR
(African League Against Rheumatism) congresses in the 1990’s. Author’s personal database.
All cited references read in full.
Conclusions: The evidence shows rheumatoid arthritis and systemic lupus erythematosus to
be increasing in frequency in the indigenous populations of East, Central and South Africa
but remaining rare in West Africans. Gout is now more prevalent than ever throughout the
subcontinent. HIV has spawned a variety of previously rare spondyloarthropathies (reactive
arthritis, psoriatic arthritis, enthesopathy) and changed the epidemiology of pyomyositis
and osteomyelitis. Osteoarthritis is a universal problem. Juvenile chronic arthritis is not rare
and rheumatic fever is common. Acute and chronic locomotor problems associated with
diverse entities such as leprosy, brucellosis, meningococcus, alpha viruses, parasites, fluorosis,
rickets and haemoglobinopathies enhance diagnostic diversity and therapeutic and educational
requirements. Suggestions made to address the challenge posed by the burden of rheumatic
disorders.
context of current medical practice in the region assess the need for service and educational
provision.
Data sources: Medline, (English, French). Pre-medline literature review from the 1950’s
(Current contents). Various conference reports including attendance at all three AFLAR
(African League Against Rheumatism) congresses in the 1990’s. Author’s personal database.
All cited references read in full.
Conclusions: The evidence shows rheumatoid arthritis and systemic lupus erythematosus to
be increasing in frequency in the indigenous populations of East, Central and South Africa
but remaining rare in West Africans. Gout is now more prevalent than ever throughout the
subcontinent. HIV has spawned a variety of previously rare spondyloarthropathies (reactive
arthritis, psoriatic arthritis, enthesopathy) and changed the epidemiology of pyomyositis
and osteomyelitis. Osteoarthritis is a universal problem. Juvenile chronic arthritis is not rare
and rheumatic fever is common. Acute and chronic locomotor problems associated with
diverse entities such as leprosy, brucellosis, meningococcus, alpha viruses, parasites, fluorosis,
rickets and haemoglobinopathies enhance diagnostic diversity and therapeutic and educational
requirements. Suggestions made to address the challenge posed by the burden of rheumatic
disorders.
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