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  • Review Article
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Rheumatic diseases in Africa

Nature Reviews Rheumatology volume 17, pages 363–374 (2021)Cite this article

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Abstract

Historically, rheumatic diseases have not received much attention in Africa, particularly in sub-Saharan Africa, possibly owing to a focus on the overwhelming incidence of infectious diseases and the decreased life span of the general population in this region. Global attention and support, together with better health policies and planning, have improved outcomes for many infectious diseases; thus, increasing attention is being turned to chronic non-communicable diseases. Rheumatic diseases were previously considered to be rare among Africans but there is now a growing interest in these conditions, particularly as the number of rheumatologists on the continent increases. This interest has resulted in a growing number of publications from Africa on the more commonly encountered rheumatic diseases, as well as case reports of rare diseases. Despite the limited amount of available data, some aspects of the epidemiology, genetics and clinical and laboratory features of rheumatic diseases in African populations are known, as is some detail on the use of therapeutics. Similarities and differences in these conditions can be seen across the multi-ethnic and genetically diverse African continent, and it is hoped that increased awareness of rheumatic diseases in Africa will lead to earlier diagnosis and better outcomes for patients.

Key points

  • In the past, there has been an emphasis on communicable diseases in Africa, but attention has now shifted towards non-communicable diseases such as rheumatic diseases.

  • Common rheumatic diseases are seen in Africa and are both comparable and different from presentations seen outside of Africa.

  • Diverse genetic and environmental factors affect the presentation of common rheumatic diseases among different African nations.

  • A shortage of appropriately trained staff, laboratory testing capacity and effective medications exists across the whole continent.

  • Advocacy and research are needed to increase awareness of the risk factors, presentations and management of rheumatic diseases in Africa.

  • Specialized treatment guidelines are needed for resource-poor countries in Africa.

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Acknowledgements

The authors thank A.A. Akpabio for help with the literature search and drawing up the tables.

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Authors and Affiliations

  1. Rheumatology Unit, Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria

    Olufemi Adelowo

  2. Department of Rheumatology, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa

    Girish M. Mody

  3. Division of Rheumatology, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa

    Mohammed Tikly

  4. Department of Medicine, University of Nairobi, Nairobi, Kenya

    Omondi Oyoo

  5. Atlas Clinic of Rheumatology, Batna, Algeria

    Samy Slimani

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  1. Olufemi Adelowo
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  2. Girish M. Mody
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  4. Omondi Oyoo
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  5. Samy Slimani
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Contributions

All authors researched data for the article, provided substantial contributions to discussions of content and wrote the article. O.A., G.M.M. and M.T. reviewed and/or edited the manuscript before submission.

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Correspondence to Olufemi Adelowo.

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Nature Reviews Rheumatology thanks L. Lewandowski, A. Gcelu, P. Dessein and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Related links

Global Alliance for Musculoskeletal Health: https://gmusc.com/

PAFLAR: https://paflar.org/

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Adelowo, O., Mody, G.M., Tikly, M. et al. Rheumatic diseases in Africa. Nat Rev Rheumatol 17, 363–374 (2021). https://doi.org/10.1038/s41584-021-00603-4

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