Quarterly Medical ReviewChallenges for lupus management in emerging countries
Section snippets
Methods
Published studies were searched by querying PubMed, Medline, Embase, and Cochrane. The search process used the following keywords: systemic lupus erythematous, epidemiology, registry, diagnosis, treatment, prognosis, trials, emerging countries, and developing countries, challenges, with a specific look at publications from Africa, Asia, and Latin America. The search was performed with no date limit, and then focused on the last 20 years. The populations of the emerging countries were likened to
Epidemiology
SLE has been reported all over the world. Many epidemiological studies have detailed its incidence, prevalence, and mortality rates and their distribution according to gender, age, race, and disease presentation.
However, the epidemiology of SLE in developing countries remains largely unknown and probably underestimated, while that in developed countries is known through registries and cohorts. Some of these have contributed substantially to lupus research, especially on the differences in
Discussion
Both ethnicity and SES are independently associated with disease activity and overall organ damage. However, the components of poor SES, including less optimal medical care and insurance coverage, higher level of poverty, and lack of formal education, act synergistically with SLE, contributing to greater overall organ damage and lower survival rates among minority population groups and lupus patients from emerging countries, while ethnicity appears to play a minor role. This interaction with
Conclusion
The prevalence, morbidity, and mortality associated with lupus are highest among racial and ethnic minorities, the poor, and those lacking medical insurance and education. Lack of access to healthcare, especially in medically underserved communities, may be responsible for many of the observed disparities. Multinational collaboration can help SLE research to improve the medical technology and research methods in developing countries. Appropriate educational programs for healthcare providers and
Disclosure of interest
the authors declare that they have no conflicts of interest concerning this article.
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