Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jan;7(1):e11749.
doi: 10.1002/acr2.11749. Epub 2024 Oct 9.

Challenges in Diagnosis and Management of SLE in Africa: An Online Survey

Farhanah Paruk  1 , Dzifa Dey  2 , Anisa Mosam  1 , Oluwaytoyin Amira Christina  3 , Mohammed Tikly  4
Affiliations

Challenges in Diagnosis and Management of SLE in Africa: An Online Survey

Farhanah Paruk et al. ACR Open Rheumatol. 2025 Jan.

Abstract

Objective: We surveyed African physicians about challenges in diagnosis and management of systemic lupus erythematosus (SLE).

Methods: We used a cross-sectional, online questionnaire-based survey of African specialist physicians on availability of laboratory tests, medications, and specialized services for the diagnosis of SLE.

Results: Our 226 respondents from 31 countries were dermatologists (38%), rheumatologists (28%), and nephrologists (23%), the majority practicing at university/state-funded hospitals (80.8%), but over half of patients (59.6%) were self-funded for laboratory tests and medications. Antinuclear antibody (ANA), antiphospholipid antibody, and complement tests were available to 79.4%, 67.6%, and 62.3% of respondents, respectively, but fewer in the East and West African regions. Median turnaround time for the ANA test was within two weeks but more than four weeks for 5.6% of respondents, and longer in West Africa compared with other regions (P = 0.0002). Availability of urine protein-to-creatinine test, skin and renal histopathology was 82%, 82.5%, and 76.2%, respectively. Median turnaround times were within one to two weeks, but more than four weeks for 13.8% of respondents for skin histology results and usually within four weeks but more than four weeks for 24.5% of respondents for renal histology. Glucocorticoids and antimalarials were readily available across all regions, with variable availability of immunosuppressants from 93.7% for methotrexate to 65% for calcineurin inhibitors and only 58.4% for the biologic rituximab. Intensive care units/high care facilities, hemodialysis, and renal transplantation were available to 69.8%, 91.9%, and 56.5% of respondents, respectively.

Conclusion: Variable availability of laboratory tests, medications, and supportive services coupled with cost constraints are major impediments to early diagnosis and optimal management of SLE in most of Africa and are likely factors contributing to underreporting and poor prognosis of SLE in Africa.

PubMed Disclaimer

References

    1. Demas KL, Costenbader KH. Disparities in lupus care and outcomes. Curr Opin Rheumatol 2009;21(2):102–109. - PMC - PubMed
    1. Piga M, Arnaud L. The main challenges in systemic lupus erythematosus: where do we stand? J Clin. Med 2021;10(2):243. - PMC - PubMed
    1. Fernández M, Alarcón GS, Calvo‐Alén J, et al; LUMINA Study Group . A multiethnic, multicenter cohort of patients with systemic lupus erythematosus (SLE) as a model for the study of ethnic disparities in SLE. Arthritis Rheum 2007;57(4):576–584. - PubMed
    1. Lewis MJ, Jawad AS. The effect of ethnicity and genetic ancestry on the epidemiology, clinical features and outcome of systemic lupus erythematosus. Rheumatology (Oxford) 2017;56(suppl_1):i67–i77. - PubMed
    1. Tiffin N, Hodkinson B, Okpechi I. Lupus in Africa: can we dispel the myths and face the challenges? Lupus 2014;23(1):102–111. - PubMed

LinkOut - more resources