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1995-03-04
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Document 0041
DOCN M9550041
TI Rheumatic diseases in African blacks.
DT 9505
AU Adebajo A; Davis P; Rheumatology Research Unit, Adenbrookes Hospital,
Cambridge,; England.
SO Semin Arthritis Rheum. 1994 Oct;24(2):139-53. Unique Identifier :
AIDSLINE MED/95141084
AB Contrary to previous belief, there is increasing evidence that a broad
spectrum of rheumatic diseases do affect African blacks. Although
properly conducted epidemiological studies have yet to be performed,
reports of population surveys from a variety of sub-Saharan African
countries indicate that diseases such as rheumatoid arthritis (RA),
gout, and the connective tissue diseases are observed, although some
differences in clinical presentation may occur as a result of cultural,
racial, and socioeconomic factors. Rheumatoid arthritis is common in
some parts of Africa and less common in others. In particular, a
significantly lower prevalence of RA in rural areas compared with urban
cohorts has led to the hypothesis that environmental factors associated
with urbanization may be involved in disease pathogenesis. A similar
hypothesis has been suggested for hyperuricemia and gout. Clinical
features of disease may also be different in Africans when compared with
other population subgroups such as with systemic lupus erythematosus
although this may be artefactual as different accessibility to health
care and referral practices may result in only the more severe cases
coming to medical attention (eg, lupus nephritis). Immunogenetic factors
may reduce the prevalence of some conditions such as the
spondyloarthropathies. Although the association between HLA-DR4 and RA
holds true in Africans, the same is not so for the association of
HLA-B27 with ankylosing spondylitis (AS). The prevalence of HLA-B27 in
African blacks is 10 times less than Caucasian populations, in part
accounting for the low prevalence of spondyloarthropathies, although its
association with AS is low. Other conditions such as human
immunodeficiency virus (HIV)-related arthropathies appear to be an
increasing medical problem. The panepidemic of acquired immunodeficiency
syndrome in Africa has resulted in an increased awareness of the
different types of arthritis that may be associated with HIV. These are
similar to those reported in other parts of the world, although risk
factors are different in Africa where heterosexual transmission is a
more common cause than homosexual transmission or i.v. drug usage.
Information on other rheumatic diseases such as osteoarthritis and soft
tissue rheumatism are slowly emerging. Rheumatic manifestations of the
infectious diseases, which are endemic in Africa, remain a uniquely
fascinating aspect of rheumatology practice on the African continent.
Therefore, African countries will increasingly be a continued valuable
source of clinical material for comparative studies to help elucidate
factors that influence the development of rheumatic diseases.
DE Africa/EPIDEMIOLOGY Human *Negroid Race Prevalence Rheumatic
Diseases/*EPIDEMIOLOGY/PHYSIOPATHOLOGY Support, Non-U.S. Gov't JOURNAL
ARTICLE REVIEW REVIEW, ACADEMIC
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).