Spondyloarthritis in Senegal: a study of 770 cases

Abstract

Background: Very few studies have focused on spondyloarthritis (SpA) in sub-Saharan Africa. The majority of these studies have focused on series of HLA B27-negative SpA.

Objective: To determine the epidemiological, diagnostic, therapeutic and evolutionary aspects of SpA in the rheumatology department of the CHU Aristide LeDantec in Dakar, Senegal.

Methods: We conducted a retrospective, descriptive, analytical study from January 1, 2012 to December 31, 2020, of patients with spondyloarthritis diagnosed according to the ESSG (54.5%), Amor (52.5%), modified New York criteria (48.3%) and ASAS (23%). For each patient, the following information was collected: sex, age, occupation, family history of spondyloarthritis in the parents, time to diagnosis, type of SpA.

Results: 770 observations were collected from 273 men (35.5%) and 497 women (64.5%). Ankylosing spondylitis (AS) was the most frequent type of SpA in our series with 84% of cases. A biological inflammatory syndrome was present in 77.27% of our patients. HLA B27 phenotyping was performed in 437 patients, of which 225 were HLA B27 positive (51.48%). The majority of our patients were under conventional treatment due to the high cost of biotherapies which limits their prescription.

Conclusion: The profile of SpA patients in our series was characterised by : the predominance of females, the later age of onset, the frequency of radiographic axial forms of SpA and the biological inflammatory syndrome. HLA B27 was present in one patient out of two, as in the North African series.