Systemic sclerosis in sub-Saharan Africa: a systematic review

Area of Science:

• Rheumatology
• Autoimmune Diseases
• Epidemiology

Background:

• Systemic sclerosis (SSc) research is limited in sub-Saharan Africa.
• Understanding regional variations in SSc is crucial for effective management.

Purpose of the Study:

• To systematically review and analyze published clinical data on SSc in sub-Saharan Africa.
• To identify epidemiological patterns and clinical features of SSc in this population.

Main Methods:

• Systematic literature review following PRISMA guidelines.
• Searched Embase, PubMed, and African Health Sciences databases up to March 2018.
• Analyzed 91 publications reporting on 1884 patients.

Main Results:

• Predominant publications from South Africa, Nigeria, and Senegal.
• High prevalence of diffuse SSc (72%), Raynaud's phenomenon (78%), and skin ulcerations (42%).
• Frequent interstitial lung disease (50%), pulmonary hypertension (30%), and esophageal reflux (70%).
• Distinct antibody profile: anti-fibrillarin (16.5%) common, anti-centromere and anti-RNA polymerase 3 rare.
• Focal skin hypopigmentation common; telangiectasia infrequent.

Conclusions:

• SSc in sub-Saharan Africa presents differently than in Europe/America, with more diffuse skin disease and hypopigmentation.
• A higher prevalence of anti-fibrillarin antibodies is noted in this population.
• Further research is needed to address the scarcity of SSc studies in sub-Saharan Africa.