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- Title
Ankylosing spondylitis in sub-Saharan Africa.
- Authors
Belachew, D. A.; Sandu, N.; Schaller, B.; Guta, Z.
- Abstract
Ankylosing spondylitis (AS) represents a chronic inflammatory bone disease of the axial skeleton that manifests as chronic back pain and progressive stiffness of the spine. It characteristically affects young adults with a peak age of onset between 20-30 years. In contrast to Western Europe and North America, the disease is rare in Sub-Saharan Africa where the majority of the population is HLA-B27 negative. Even in some African populations where HLA-B27 is prevalent (for example, in Gambia and Senegal, where 3-6% of the general population has HLA-B27), the disease is also said to be rare. However, some other genetic markers may be involved in the causation of AS in the HLA-B27 negative population, and when it occurs in this subgroup of patients it has a similar manifestation with HLA-B27 negative white patients and these patients rarely develop anterior uveitis. The clinical presentation of the disease in Africa is generally milder; most affected individuals do not have a family history of AS, the patients are older at onset of the disease, and the majority of them lack extra-articular manifestations such as anterior uveitis compared with the situation in Western Europe and North America. In conclusion, AS in sub-Saharan Africa seems to represent a subgroup of the disease, which may open the window to a greater understanding of the pathophysiology of the condition.
- Subjects
SUB-Saharan Africa; WESTERN Europe; NORTH America; ANKYLOSING spondylitis; BONE diseases; GENETIC markers; ETIOLOGY of diseases; PATHOLOGICAL physiology
- Publication
Postgraduate Medical Journal, 2009, Vol 85, Issue 1005, p5
- ISSN
0032-5473
- Publication type
Article
- DOI
10.1136/pgmj.2007.064717