Objectives: Systemic lupus erythematosus (SLE) is an autoimmune disorder with a poorly understood aetiology. It predominantly affects females and has a variety of clinical manifestations. In Nigeria, there are limited data on the prevalence and burden of the disease. This study aimed to determine the clinical and laboratory profiles of SLE patients seen in a new rheumatology clinic in South-South Nigeria. Material and methods: This was a retrospective cross-sectional study conducted over five years (January 2016 to December 2020). The case files of patients that satisfied the diagnosis of SLE were reviewed. The diagnosis was based on the 1997 update of the American College of Rheumatology revised criteria for the classification of SLE. The sociodemographic, clinical, and immunological data were extracted from case records. Data analysis was carried out using IBM SPSS statistics® 2012 version 21.0. Results: Fifty-two patients were diagnosed with SLE, giving a frequency of 4.7%. Forty-seven (90.4%) of the study participants were females, with a female-to-male ratio of 9.4 : 1. The mean age of the study group was 28.42 years. The mean duration of disease before diagnosis was 4.04 months with a range of 1-15 months. The patients had various organ system manifestations, with polyarthritis being the commonest (86.5%). Others included mucocutaneous (78.8%), haematological (69.2%), serositis (40.4%), renal (38.5%), and neurological (25%) manifestations. Antinuclear antibody (ANA) assay and anti-double-stranded DNA were positive in 100% and 69.2% of patients, respectively. All patients were placed on steroids, and 96.2% had hydroxychloroquine. None of the patients were on biologic disease-modifying antirheumatic drugs. Conclusions: This study's results are consistent with data from other African countries. To fully understand the burden and epidemiology of SLE in Nigeria, a larger prospective study is needed.
Background Fibromyalgia is a chronic pain syndrome of unknown etiology characterized by chronic widespread musculoskeletal pain and tenderness. It affects the quality of life of patients and has been associated with the human immunodeficiency virus (HIV). The study aimed to determine the prevalence of fibromyalgia in HIV‐positive patients and assess the effect of fibromyalgia on their functional status. Methodology This was a cross‐sectional study comprising 160 treatment‐naive HIV‐positive patients and 160 age‐ and sex‐matched HIV‐negative controls. The diagnosis of fibromyalgia was based on the 2011 modification of the 2010 American College of Rheumatology diagnostic criteria by assessing the widespread pain index and symptom severity score. The severity of fibromyalgia was assessed with the revised fibromyalgia impact questionnaire. Results The prevalence of fibromyalgia in HIV‐positive individuals was found to be 10.6%, which was significantly higher compared with controls (3.1%; P = .008). There was no significant association between fibromyalgia and age, gender, or occupation. There was a significant relationship between CD4 count levels (P < .001), WHO clinical stage (P < .001), and fibromyalgia. A statistically significant higher score on the Revised FM Impact Questionnaire was found in HIV‐positive individuals with fibromyalgia (P < .001). Conclusion The study found that HIV‐positive patients had a significantly higher incidence of fibromyalgia than controls and this was related to active indices of HIV disease. Fibromyalgia had a greater clinical impact on HIV patients than in controls. As a result, fibromyalgia should be identified and treated in people living with HIV.
Background: Soft tissue rheumatism arises from the pathology of periarticular structures. They are marked by pain and disability. Epidemiological studies in sub-Saharan Africa are sparse. This study aimed to determine the epidemiology of soft-tissue rheumatism in a rural community in South-South Nigeria. Methods: This was a community-based, cross-sectional study conducted from February to July 2017 in South-South Nigeria among 319 participants using the Community Oriented Program for the Control of Rheumatic Diseases (COPCORD) methodology. Participants aged 18 years and older were included in the study. Subjects reporting positive musculoskeletal pain were examined for specific soft tissue rheumatism. The diagnosis was based on established criteria. Results: The mean age of the study population was 48.87 ± 19.58 years.The prevalence of soft-tissue rheumatism was 11.0% (35/319). Soft tissue rheumatism was more prevalent in females (24, 68.6%) than in males (11, 31.4%). The most common form of soft-tissue rheumatism diagnosed was adhesive capsulitis (20.0%), closely followed by rotator cuff tendinitis (14.3%), carpal tunnel syndrome (14.3%), and plantar fasciitis (14.3%). Age (p = 0.06), body mass index (p = 0.034), and dyslipidemia (p = 0.028) were significantly associated with the prevalence of soft-tissue rheumatism. A significant disability index (HAQ-DI ≥ 1) was recorded in 40.0% of participants with soft tissue rheumatism. Twelve (34.3%) participants with soft-tissue rheumatism attributed the disorder to their work, and 74.3% used hospital-prescribed medications for treatment. Conclusion: Soft-tissue rheumatism is associated with a significant disability affecting activities of daily living. Factors associated with its prevalence include increasing age and obesity.
Adult-Onset Still’s Disease (AOSD) is an uncommon multisystemic inflammatory disease of no known aetiology.1 Bywaters in 1971 was the first to describe this clinical entity.2,3 Its estimated annual incidence is 0.16 per 100,000 persons.4 AOSD has a bimodal pattern of age distribution with peaks at 15 - 25 and 36 - 46 years. This shows that young adults are mainly affected. 4 It is characterised by daily high spiking fever, evanescent salmon coloured rash, polyarthritis, leucocytosis, and negative immunological study.5 The rarity of the condition has led to a low index of suspicion among clinicians. Four cases of AOSD have been reported so far in Nigeria,6–8 with the first reported in 2015 by Akintayo et al.6 We report the fifth case of AOSD diagnosed at a rural tertiary facility in South-south Nigeria.
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