       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).

