Estimating the burden of rheumatoid arthritis in Africa: A systematic analysis
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Background Rheumatoid arthritis (RA) has an estimated worldwide
prevalence of 1%. It is one of the leading causes of chronic morbidity
in the developed world, but little is known about the disease burden
in Africa. RA is often seen as a minor health problem and has
been neglected in research and resource allocation throughout Africa
despite potentially fatal systemic manifestations. This review
aims to identify all relevant epidemiological literature pertaining to
the occurrence of RA in Africa and calculate the prevalence and burden
of disease.
Methods A systematic literature review of Medline, Embase and
Global Health Library retrieved a total of 335 publications, of which
10 population studies and 11 hospital studies met pre–defined minimum
criteria for relevance and quality. Data on prevalence was extracted,
analysed and compared between population and hospital
studies. Differences between genders were also analysed.
Results The estimated crude prevalence of RA in Africa based on
the available studies was 0.36% in 1990, which translates to a burden
of 2.3 million affected individuals in 1990. Projections for the
African population in 2010 based on the same prevalence rates
would suggest a crude prevalence of 0.42% and the burden increased
to 4.3 million. Only 2 population studies have been conducted
after 1990, so projections for 2010 are uncertain. Hospital–
based studies under–report the prevalence by about 6 times in
comparison to population–based studies.
Conclusion The availability of epidemiological information on RA
in Africa is very limited. More studies need to be conducted to estimate
the true burden and patterns of RA before appropriate health
policies can be developed
Keywords
QH301 Biology, R Medicine (General)