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Challenges for lupus management in emerging countries.

Zoubida Tazi Mezalek1, Wafaa Bono2

  • 1Université Mohamed V Souissi, Faculté de médecine et de pharmacie, 10000 Rabat, Morocco; Ibn Sina University Hospital, internal medicine department, 10000 Rabat, Morocco.

Presse Medicale (Paris, France : 1983)
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Summary
This summary is machine-generated.

Systemic lupus erythematosus (SLE) in emerging countries leads to poor outcomes due to socioeconomic factors and healthcare access. Addressing diagnostic delays, infections like tuberculosis, and treatment adherence is crucial for improving lupus prognosis.

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Area of Science:

  • Rheumatology
  • Public Health
  • Global Health

Background:

  • Systemic lupus erythematosus (SLE) presents significant challenges in emerging countries, including higher disease activity, cumulative damage, disability, and mortality.
  • Disparities in SLE outcomes are linked to poor socioeconomic status (SES), limited healthcare access, and diagnostic delays, particularly affecting minority groups and those in underserved regions.
  • Infections, notably tuberculosis, are a major cause of morbidity and mortality in SLE patients from endemic areas, necessitating systematic screening and prophylaxis.

Purpose of the Study:

  • To identify factors influencing adverse outcomes in systemic lupus erythematosus (SLE) patients in emerging countries.
  • To highlight the impact of socioeconomic status, diagnostic delays, and treatment adherence on SLE prognosis.
  • To emphasize the need for targeted interventions, including infection screening and accessible treatments, to improve SLE management in resource-limited settings.

Main Methods:

  • Review of longitudinal and observational prospective studies and registries focusing on SLE outcomes in emerging countries.
  • Analysis of factors contributing to disease activity, organ damage (especially renal), disability, and mortality.
  • Evaluation of the role of socioeconomic status, healthcare access, diagnostic timeliness, infection prevalence, and treatment adherence.

Main Results:

  • Poor socioeconomic status, diagnostic delays, and limited healthcare access are strongly associated with unfavorable SLE outcomes.
  • Infections, particularly tuberculosis in endemic regions, significantly contribute to morbidity and mortality.
  • Poor adherence to treatment, often due to low education and financial barriers, exacerbates disease flares, hospitalization rates, and renal prognosis.

Conclusions:

  • Improving SLE prognosis in emerging countries requires addressing socioeconomic determinants, ensuring timely diagnosis, and managing infections effectively.
  • Systematic tuberculosis screening and prophylaxis are recommended for SLE patients from endemic areas.
  • Optimizing access to affordable immunosuppressive and corticoid-sparing agents, including generic options, is vital for better patient outcomes.