Challenges in Diagnosis and Management of SLE in Africa: An Online Survey
Objective We surveyed African physicians about challenges in diagnosis and management of systemic lupus erythematosus (SLE). Methods We used a cross‐sectional, online questionnaire–based survey of African specialist physicians on availability of laboratory tests, medications, and specialized service...
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| Format: | Article |
| Language: | English |
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Wiley
2025-01-01
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| Series: | ACR Open Rheumatology |
| Online Access: | https://doi.org/10.1002/acr2.11749 |
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| author | Farhanah Paruk Dzifa Dey Anisa Mosam Oluwaytoyin Amira Christina Mohammed Tikly |
| author_facet | Farhanah Paruk Dzifa Dey Anisa Mosam Oluwaytoyin Amira Christina Mohammed Tikly |
| author_sort | Farhanah Paruk |
| collection | DOAJ |
| description | Objective We surveyed African physicians about challenges in diagnosis and management of systemic lupus erythematosus (SLE). Methods We used a cross‐sectional, online questionnaire–based survey of African specialist physicians on availability of laboratory tests, medications, and specialized services for the diagnosis of SLE. Results Our 226 respondents from 31 countries were dermatologists (38%), rheumatologists (28%), and nephrologists (23%), the majority practicing at university/state‐funded hospitals (80.8%), but over half of patients (59.6%) were self‐funded for laboratory tests and medications. Antinuclear antibody (ANA), antiphospholipid antibody, and complement tests were available to 79.4%, 67.6%, and 62.3% of respondents, respectively, but fewer in the East and West African regions. Median turnaround time for the ANA test was within two weeks but more than four weeks for 5.6% of respondents, and longer in West Africa compared with other regions (P = 0.0002). Availability of urine protein‐to‐creatinine test, skin and renal histopathology was 82%, 82.5%, and 76.2%, respectively. Median turnaround times were within one to two weeks, but more than four weeks for 13.8% of respondents for skin histology results and usually within four weeks but more than four weeks for 24.5% of respondents for renal histology. Glucocorticoids and antimalarials were readily available across all regions, with variable availability of immunosuppressants from 93.7% for methotrexate to 65% for calcineurin inhibitors and only 58.4% for the biologic rituximab. Intensive care units/high care facilities, hemodialysis, and renal transplantation were available to 69.8%, 91.9%, and 56.5% of respondents, respectively. Conclusion Variable availability of laboratory tests, medications, and supportive services coupled with cost constraints are major impediments to early diagnosis and optimal management of SLE in most of Africa and are likely factors contributing to underreporting and poor prognosis of SLE in Africa. |
| format | Article |
| id | doaj-art-c49365671fab45f0ae2a50f871be21cd |
| institution | Kabale University |
| issn | 2578-5745 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | ACR Open Rheumatology |
| spelling | doaj-art-c49365671fab45f0ae2a50f871be21cd2025-02-04T06:21:23ZengWileyACR Open Rheumatology2578-57452025-01-0171n/an/a10.1002/acr2.11749Challenges in Diagnosis and Management of SLE in Africa: An Online SurveyFarhanah Paruk0Dzifa Dey1Anisa Mosam2Oluwaytoyin Amira Christina3Mohammed Tikly4University of KwaZulu Natal South AfricaUniversity of Ghana, Medical School Accra GhanaUniversity of KwaZulu Natal South AfricaCollege of Medicine University of Lagos NigeriaChris Hani Baragwanath Academic Hospital, University of the Witwatersrand South AfricaObjective We surveyed African physicians about challenges in diagnosis and management of systemic lupus erythematosus (SLE). Methods We used a cross‐sectional, online questionnaire–based survey of African specialist physicians on availability of laboratory tests, medications, and specialized services for the diagnosis of SLE. Results Our 226 respondents from 31 countries were dermatologists (38%), rheumatologists (28%), and nephrologists (23%), the majority practicing at university/state‐funded hospitals (80.8%), but over half of patients (59.6%) were self‐funded for laboratory tests and medications. Antinuclear antibody (ANA), antiphospholipid antibody, and complement tests were available to 79.4%, 67.6%, and 62.3% of respondents, respectively, but fewer in the East and West African regions. Median turnaround time for the ANA test was within two weeks but more than four weeks for 5.6% of respondents, and longer in West Africa compared with other regions (P = 0.0002). Availability of urine protein‐to‐creatinine test, skin and renal histopathology was 82%, 82.5%, and 76.2%, respectively. Median turnaround times were within one to two weeks, but more than four weeks for 13.8% of respondents for skin histology results and usually within four weeks but more than four weeks for 24.5% of respondents for renal histology. Glucocorticoids and antimalarials were readily available across all regions, with variable availability of immunosuppressants from 93.7% for methotrexate to 65% for calcineurin inhibitors and only 58.4% for the biologic rituximab. Intensive care units/high care facilities, hemodialysis, and renal transplantation were available to 69.8%, 91.9%, and 56.5% of respondents, respectively. Conclusion Variable availability of laboratory tests, medications, and supportive services coupled with cost constraints are major impediments to early diagnosis and optimal management of SLE in most of Africa and are likely factors contributing to underreporting and poor prognosis of SLE in Africa.https://doi.org/10.1002/acr2.11749 |
| spellingShingle | Farhanah Paruk Dzifa Dey Anisa Mosam Oluwaytoyin Amira Christina Mohammed Tikly Challenges in Diagnosis and Management of SLE in Africa: An Online Survey ACR Open Rheumatology |
| title | Challenges in Diagnosis and Management of SLE in Africa: An Online Survey |
| title_full | Challenges in Diagnosis and Management of SLE in Africa: An Online Survey |
| title_fullStr | Challenges in Diagnosis and Management of SLE in Africa: An Online Survey |
| title_full_unstemmed | Challenges in Diagnosis and Management of SLE in Africa: An Online Survey |
| title_short | Challenges in Diagnosis and Management of SLE in Africa: An Online Survey |
| title_sort | challenges in diagnosis and management of sle in africa an online survey |
| url | https://doi.org/10.1002/acr2.11749 |
| work_keys_str_mv | AT farhanahparuk challengesindiagnosisandmanagementofsleinafricaanonlinesurvey AT dzifadey challengesindiagnosisandmanagementofsleinafricaanonlinesurvey AT anisamosam challengesindiagnosisandmanagementofsleinafricaanonlinesurvey AT oluwaytoyinamirachristina challengesindiagnosisandmanagementofsleinafricaanonlinesurvey AT mohammedtikly challengesindiagnosisandmanagementofsleinafricaanonlinesurvey |