The outlook of rheumatological care in Africa: Current state, challenges, and recommendation

Aderinto, Nicholas; Alare, Kehinde; Opeyemi, Muili AbdulBasit; Oluwatosin, Adekanle

doi:10.1016/j.amsu.2022.104689

Cited by 6 publications

(9 citation statements)

References 15 publications

(19 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite an increase in hospital-based reports of systemic autoimmune rheumatic diseases (SARDs) in Africa, the rural community prevalence seems low [13,[32][33][34][35].…”

Section: Discussionmentioning

confidence: 99%

“…This has been attributable to inadequate diagnostic capacity and lack of access to rheumatologists [32].…”

Section: Discussionmentioning

confidence: 99%

“…Access to rheumatic-musculoskeletal services should be improved in Africa, where there is a dearth of rheumatology manpower and a lack of diagnostic and management tools [32,39]. A possible temporary solution may be the use of nurses and healthcare workers for such care.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Epidemiology of rheumatic and musculoskeletal diseases in a Nigerian peri-urban community: results of a cross-sectional survey using the COPCORD stage 1 model

Olufemi¹,

Hakeem²,

Olalade³

et al. 2022

Reumatologia

View full text Add to dashboard Cite

ObjectivesThere is relative neglect of rheumatic and musculoskeletal diseases (RMDs) in sub-Saharan Africa (SSA). While hospital-based reports on RMDs abound, there is a paucity of population-based reports on these conditions which are otherwise recognized to cause functional disability and reduced quality of life in the affected individuals. Thus, the objective of this study is to determine the prevalence, diagnostic types, and predictors of musculoskeletal (MSK) pain in Agbowa, a peri-urban community in Lagos, South-West Nigeria.Material and methodsThis community-based survey utilized the World Health Organisation/International League of Association of Rheumatology Community Oriented Programme for the Control of Rheumatic Diseases (WHO/ILAR COPCORD) stage 1 model. All respondents had their profiles documented via modified COPCORD questionnaires. Pain intensity and functional disability were assessed by the Numerical Rating Scale (NRS) and Health Assessment Questionnaires Disability Index (HAQ-DI) respectively. The rheumatic and musculoskeletal diseases were classified using relevant validated criteria. Data obtained were analysed using SPSS Version 21.ResultsThere were 3056 respondents who were predominantly female (59.2%). The period prevalence of MSK pain among the 3056 respondents was 58% (n = 1,773). There were significantly more females with MSK pain than males (62.8% vs. 37.2%, p = 0.001). Overall, 380 (12.4%) subjects had clinically diagnosed RMDs. The common RMDs in decreasing order were osteoarthritis (n = 185, 6.1%), chronic low back pain (n = 95, 3.1%) and soft tissue rheumatism (n = 52, 1.7%). The bivariate analysis showed that female sex, family history of MSK conditions, history of previous trauma, and some comorbidities were significantly associated with MSK pain. The median HAQ-DI was 0.6 (IQR 0.1–1.8) with significant disability (HAQ-DI ≥ 1) in 39.5% of the subjects.ConclusionsThe burden and impacts of these conditions are considerable. Thus, the government needs to devise programmes and policies to limit the effects of RMDs in such communities.

show abstract

“…Despite an increase in hospital-based reports of systemic autoimmune rheumatic diseases (SARDs) in Africa, the rural community prevalence seems low [13,[32][33][34][35].…”

Section: Discussionmentioning

confidence: 99%

“…This has been attributable to inadequate diagnostic capacity and lack of access to rheumatologists [32].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Epidemiology of rheumatic and musculoskeletal diseases in a Nigerian peri-urban community: results of a cross-sectional survey using the COPCORD stage 1 model

Olufemi¹,

Hakeem²,

Olalade³

et al. 2022

Reumatologia

View full text Add to dashboard Cite

show abstract

“…All patients start at moderate disease activity. 2 Early -drug is started after methotrexate failure 3 Late -treatment after both methotrexate and triple therapy failure.…”

Section: Effectivenessmentioning

confidence: 99%

“…In sub-Saharan African (SSA) populations, the prevalence of RA is estimated to be between 0.6 and 1.0% (1,2). With low treatment coverage, RA is included among the significantly neglected chronic disease (3). People with RA experience reduced physical functioning, quality of life, and life expectancy (4).…”

Section: Introductionmentioning

confidence: 99%

Treating Rheumatoid Arthritis in Zanzibar: a cost effectiveness study comparing conventional, biologic, and targeted-synthetic disease modifying anti-rheumatic drugs

Said,

Kühl,

Fevang

et al. 2023

Preprint

View full text Add to dashboard Cite

To evaluate the cost effectiveness of six disease modifying anti-rheumatic drug (DMARD) treat-to-target treatment strategies for patients with rheumatoid arthritis in Zanzibar.A Markov model was used to calculate the cost-effectiveness of various DMARD strategies in the treatment of rheumatoid arthritis over a three-year period. A health-provider perspective was used and only outpatient costs were considered. The Clinical Disease Activity Index (CDAI) was utilized for measurement of efficacy and values were obtained from literature. Quality Adjusted Life Years (QALYs) were obtained from 122 patients attending the rheumatology clinic at Mnazi Mmoja Hospital. Data on costs were obtained from the central medical stores and hospital administration. Treatment strategies were given in sequential approach based on treat to target goals of therapy. This included methotrexate monotherapy, methotrexate + sulfasalazine + hydroxychloroquine, methotrexate followed by one or two biologic/targeted-synthetic DMARDs (b/tsDMARDs). Probabilistic and one way sensitivity analysis were performed. Scenario analysis was undertaken comparing drug prices from India and Scandinavia.Costs of therapy/patient/three years ranged from USD 634 for methotrexate monotherapy and USD 5011 for methotrexate and two consecutive b/tsDMARDs. The highest and lowest effects were 2.209 and 2.079 QALYs gained from methotrexate therapy + two consecutive b/tsDMARDs and methotrexate monotherapy, respectively. From a healthcare perspective methotrexate monotherapy was the cost-effective option at a willingness to pay of USD 282. Pairwise comparison also favored methotrexate monotherapy as the feasible option. We found that increasing the willingness to pay led to a change in the most acceptable option from methotrexate monotherapy to methotrexate followed by b/tsDMARD.Methotrexate monotherapy is the cost-effective option for the management of rheumatoid arthritis in Zanzibar. Other options may be feasible if the willingness to pay threshold is increased or the drug prices are lowered, particularly for the b/tsDMARDs.

show abstract

Comorbidities in Nigerian patients with rheumatoid arthritis

Adelowo,

Omokhowa,

Ochiagha

et al. 2023

Clin Rheumatol

View full text Add to dashboard Cite

The outlook of rheumatological care in Africa: Current state, challenges, and recommendation

Cited by 6 publications

References 15 publications

Epidemiology of rheumatic and musculoskeletal diseases in a Nigerian peri-urban community: results of a cross-sectional survey using the COPCORD stage 1 model

Epidemiology of rheumatic and musculoskeletal diseases in a Nigerian peri-urban community: results of a cross-sectional survey using the COPCORD stage 1 model

Treating Rheumatoid Arthritis in Zanzibar: a cost effectiveness study comparing conventional, biologic, and targeted-synthetic disease modifying anti-rheumatic drugs

Comorbidities in Nigerian patients with rheumatoid arthritis

Contact Info

Product

Resources

About