TITLE:
Challenges of Rheumatoid Arthritis Management in Sub-Saharan Africa in the 21st Century
AUTHORS:
Malewe Kolou
KEYWORDS:
Rheumatoid Arthritis, Black Africa, Rheumatoid Factor, Anti-Cyclic Citrullinated Peptide Antibodies
JOURNAL NAME:
Open Journal of Rheumatology and Autoimmune Diseases,
Vol.13 No.1,
February
9,
2023
ABSTRACT: In recent decades, several advances have been made in
the management of rheumatoid arthritis (RA) both in the diagnostic field and in
the therapeutic field. Unfortunately, RA remains poorly studied in black
Africa. Epidemiological data are rare and controversial. The estimated
prevalence of RA in Africa is about 0% - 2.54%. Risk factors associated with RA
must be studied by taking into account special features of black Africa such as
the low tobacco consumption in certain regions, the tropical climate and the
high frequency of endemic parasitic and viral infections. The initially
supposed mildness of RA in black Africa is increasingly challenged. The diagnosis
is often made too late because of the scarcity of rheumatologists and
ignorance. Diagnostic tools are limited to the clinical data, the erythrocyte
sedimentation rate and radiographs as the other tools are poorly available. In
addition, there are misconceptions in African communities, responsible for loss of sight
during follow-up and treatment discontinuations. This is exacerbated by the
shortage of disease-modifying anti-rheumatic drugs (DMARDs) and the inability
to afford them. Furthermore, biological agents are very difficult to access.
Further studies are essential to better understand the characteristics of RA in
black Africa. Thus, collaborations between African and Western research teams seem
very important. In order to make available the DMARDs especially biological
agents, pharmaceutical companies can contribute through research partnerships.
Moreover, governments should provide a better place for chronic inflammatory diseases in the programs
against non-communicable diseases. Finally, training must also be promoted to
increase the number of specialists and the level of knowledge of other health
workers.