       Document 0482
 DOCN  M9460482
 TI    [Rheumatic diseases in black Africa]
 DT    9404
 AU    Mijiyawa M; Service de Rhumatologie du CHU-Tokoin de Lome.
 SO    Rev Rhum Ed Fr. 1993 Jun;60(6):451-7. Unique Identifier : AIDSLINE
       MED/94169901
 AB    There have been few epidemiological studies of bone and joint diseases
       in black Africa. Available data were generated by hospital studies which
       were inevitably flawed by selection bias. They found that the incidence
       and/or severity of rheumatoid arthritis were reduced in West Africa but
       not in urban areas of Southern and East Africa, as compared with
       industrialized countries. Ankylosing spondylitis was infrequent. The
       human immunodeficiency virus epidemic can be expected to increase the
       prevalence of spondyloarthropathies despite the fact that few black
       Africans are HLA B27-positive. Gout was the most common inflammatory
       joint disease seen in inpatients in West Africa and Equatorial Africa.
       Osteoarthritis of the fingers or hip and dysplasia of the hip were
       infrequent. The main causes of hip symptoms were sickle cell anemia and
       hemoglobin C disease whose manifestations include bone necrosis,
       osteomyelitis, and attacks of bone and joint pain. Osteoarthritis of the
       knee was common in West and Southern Africa, especially in obese women.
       Low back pain and sciatica due to disc herniation were as common as in
       Europe. Lumbar canal stenosis appeared more common in West Africa than
       in Southern Africa, with a predominance in females. Postmenopausal
       osteoporosis was exceedingly rare. Infectious diseases were prevalent as
       a result of underindustrialization and defective hygiene. The paucity of
       rheumatologists, young mean age of the population, and scarcity of
       population-based studies are sources of bias which should be taken into
       account when interpreting the available data on rheumatological diseases
       in black Africa. In the future, more rigorous studies made possible by
       increased access to health care will provide improved insight into the
       semiology and epidemiology of bone and joint diseases in this area.
 DE    Africa South of the Sahara/EPIDEMIOLOGY  English Abstract  Female
       Hemoglobinopathies/COMPLICATIONS  Human  HIV Infections/COMPLICATIONS
       Male  Negroid Race  Rheumatic Diseases/*EPIDEMIOLOGY/ETIOLOGY  JOURNAL
       ARTICLE  REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

