Vasculitis in Africa

Abstract

Purpose of ReviewSystemic vasculitides are characterized by inflammation of blood vessel walls leading to a myriad of organ disorders depending on the size, site, and location of the affected blood vessel. The epidemiology of vasculitis in the developing world has been inadequately documented. The description of the vasculitides in Africa, both from hospital series as well as taking into consideration, previous epidemiological studies in the community, indicates that these conditions have been rare until relatively recently. In view of these past observations, this review of publications on the topic looks to shed light on the current state of vasculitis in Africa.Recent FindingsTakayasu and Kawasaki appear to be the most commonly reported vasculitides in Africa. Most of the published reports are from North and South Africa. Furthermore, the contribution of vasculitis associated with infections, and in particular HIV, is significant.SummaryThere are increasing numbers of publications reflecting a growing recognition of the vasculitides in Africa.

Гігантоклітинний Артеріїт: Епідеміологія, Діагностика, Прогноз

“…Earlier referred to as a temporal arteritis, GCA (or Horton's disease) is considered the most common systemic vasculitis in the individuals over 50 years of age [4,[17][18]26] or, more generally, in adults [13,16]. GCA's principal epidemiological indices are rather varied: they are high in the West, especially in the Northern Europe, Scandinavia, Great Britain, among the Caucasian population, and quite low in Asia and Africa [6, [27][28]. These discrepancies could be attributed in part to the imperfect nomenclature, diagnostic methodology, and factual data registering.…”

“…Thus, GCA incidence varies from 1,6 to 32,8 per 100,000 people over 50 [15]: in the Northern Europe reaching 15-33 [23, 29], in Germany -3,5 [18,30], in the UK -10, and its peak (74 per 100,000) occurring in women of 70-79 years [31]. According to E. Genda et al (2018), in Tunisia, GCA is more common in men than in women [27].…”

“…The results of our analysis of the papers devoted to clinical features GCA in various ethnic groups do not allow to exclude influence of selection bias. For instance, it is the cranial symptoms that prevail in the recent description of GCA in the Africans: headache is present in 91,7% Лекції, огляди / Lectures, Reviews of cases, temporal arterial abnormalities in 85,4%, "severe ischemic signs" in 80,2%; frequency of constitutional symptoms achieves 75%, PMR -56,3%, large vessel manifestations are not mentioned [27]. At the same time, whenever the LV-GCA is in the Europeans revealed, their clinical picture description is full of upper limb ischemia while PMR and cranial ischemia symptoms are either omitted altogether or mentioned as often as while describing the classical GCA [49][50].…”

“…The results of studying clinical and laboratory features as well as use of imaging tests to diagnose the vascular damages in GCA and TA are summarized in Table 6. It's worthy of noting that TA is very rare (incidence 0,5-3 per 1 million people), mainly occurs in Asia, and even there the distribution of vascular damages is not homogeneous: the Japanese and Korean patients more often have their aortal arch damaged, the Indian and Thai patients (as well as the European and Tunisian ones) more often have their abdominal aorta damaged [27][28].…”

“…aortic dilatation or aneurysm detected), the relevant guidelines on aortal aneurysm management should be followed with control examinations every 6-12 months. With negative screening, imaging tests are to be repeated every 5 years [27,28].…”