Evaluation of Therapeutic Adherence in Patients Suffering from Chronic Inflammatory Rheumatism in the Rheumatology Wards of Lomé (Togo)

Objectives: Therapeutic compliance can be defined as the degree of adequacy between a patient’s behaviour and his doctor’s recommendations. Non-adherence to treatment has serious consequences in terms of morbidity and mortality. Our aim was to assess adherence among patients treated for chronic inflammatory rheumatism in Lomé. Patients and Methods: This was a multicentre cross-sectional study conducted from January 2015 to December 2021. Patients aged 18 years or older, treated in the rheumatology departments of the Sylvanus Olympio University Hospital or the Bè Hospital during the study period, were included if they were diagnosed with chronic inflammatory rheumatism and started on disease-modifying therapy. Adherence was assessed using the Compliance Questionnaire Rheumatology 19 questionnaire, with a threshold for good compliance set at 80%. Results: Out of 13,214 patients received, 159 suffered from chronic inflammatory rheumatism (hospital frequency 1.5%), and 60 met the inclusion criteria for our study. There were 55 women (91.7%) and 5 men (8.3%), giving a sex-ratio of 1/11. The mean age was 49.5 ± 13.5 years (extremes: 19 and 78 years). Rheumatoid arthritis (68.3%) was the most common rheumatic disease, followed by undefined rheumatic diseases (16.6%) and spondyloarthritis (8.3%). Average compliance with treatment was 76.9% ± 12.4% (extremes 29.8 and 91.2). There was no statistically significant difference according to the type of rheumatism. Conclusion: Overall compliance was poor, with a Compliance Questionnaire Rheumatology 19 of less than 80%. It was non-significantly influenced by socioeconomic status, disease severity and duration of progression.

Epidemiological and Clinical Aspects of Hospitalized Patients with Chronic Rheumatic Disease at Cocody University Hospital in Abidjan

Objective: To study the epidemiological and diagnostic features of chronic rheumatic disease (CRD) in a black population in sub-Saharan Africa. Patients and Methods: Retrospective descriptive study over eight years (January 2005 to December 2012) of patients seen for CRD in rheumatology hospitalization at the CHU de Cocody in Abidjan, Côte d’Ivoire. Results: Of 3147 hospitalized patients, 92 had CRD, a frequency of 2.9%. The mean age of patients was 43.50 ± 15.6 years (extremes: 10 to 79 years). The sex ratio was 0.08 (7 men and 85 women). The socio-economic level was low in 44 patients (47.8%), medium in 44 patients (47.8%), and high in 4 patients (4.4%). The reasons for consultation were polyarthritis (64.1%), polyarthralgia (30.4%), and oligoarthritis (5.4%). The mean duration of symptomatology was 19 months (range: 3 to 20 years). The mean length of hospital stay was 14.2 ± 7.7 days (range: 2 to 36 days). The CRD observed were: rheumatoid arthritis (59.8%), systemic lupus erythematosus (23.9%), mixed connective tissue disease (6.5%), undifferentiated connective tissue disease (3.3%), polymyositis (3.3%), systemic scleroderma (2.2%), and systemic vasculitis (1%). Conclusion: CRD is not uncommon in rheumatology hospitals in Abidjan. Diagnostic delays are long, and rheumatoid arthritis and systemic lupus erythematosus are the most frequently encountered conditions.

Cardiovascular Disease Risk Associated to Chronic Inflammatory Rheumatic Diseases in Patients Seen in Rheumatology Unit in Yaounde, Cameroon

Introduction: Even though there is a huge burden of both chronic inflammatory rheumatic diseases (CIRD) and cardiovascular diseases in Sub-Saharan Africa, no published study from this region has yet addressed the issue of cardiovascular diseases in a group including different CIRD to the best of our knowledge. Objective: We conducted this research with the aim to explore the association between CIRD and cardiovascular risk in a Cameroonian population based on the World Health Organization (WHO) and International Society for Hypertension (ISH) risk charts. Methods: This cross-sectional study included CIRD patients, followed at the rheumatology unit of the Yaounde Central Hospital, and, who were matched to non-CIRD subjects for sex, age and race. Cardiovascular risk factors were studied and subsequently the cardiovascular risk was estimated using the WHO/ISH risk charts. Analyses were performed in Epi-info and SPSS software and results were considered statistically significant for a p-value less than 0.05. Results: In total, 109 CIRD patients and 111 non-CIRD subjects were included. Their respective mean ages were 44.4 ± 15.2 years and 44.2 ± 15.1 years. Odds ratio 2.09, 95% confidence interval (CI) (1.07 - 4.08);high BMI OR 1.89, 95% CI (1.1 - 3.24);diabetes mellitus (p = 0.03) and physical inactivity (p < 0.001) were all markedly found in CIRD patients compared with controls. Ten (9.2%) CIRD patients had a past history of atherosclerotic cardiovascular events compared with no control (p < 0.001). The cardiovascular risk estimated with the WHO/ISH risk charts was low in 43 (79.6%) patients with CIRD versus 52 (88.1%) non-CIRD subjects. Conclusions: CIRD were associated with hypertension, excess overall adiposity, diabetes mellitus, and physical inactivity. A substantially increased proportion of CIRD patients with a past history of atherosclerotic cardiovascular events were noted. But the WHO/ISH risk charts broadly found a similar and globally decremented cardiovascular risk in both study groups, highlighting the need to pursue research for definite conclusions on their reliability.

Chronic Inflammatory Rheumatic Diseases in Rheumatological Practice in Lomé(Togo)

Chronic inflammatory rheumatism is a pathology of variable frequency and severity with a significant impact on the socio-economic, personal and family level. Study Aim: To describe the epidemiological, clinical, laboratory, radiological, therapeutic and evolutive features of chronic inflammatory rheumatic diseases in rheumatological practice in Togo. Patients and Methods: This was a multicenter cross-sectional study conducted from January 2011 to December 2019 on patients examined in the three rheumatology departments in Lomé (Togo). Patients 18 years old and above who have presented joint pain with or without synovitis, and/or rachialgia (back pain) for at least three months were included. The diagnosis of chronic inflammatory rheumatic diseases was made according to international consensus criteria. Results: Out of the 20333 patients whose files were collected during our study period, 290 (1.43%) suffered from chronic inflammatory rheumatic diseases. There were 226 (77.93%) females and 64 (22.07%) males. The mean age of the patients was 42.79 ± 15.18 years. The mean duration of symptoms was 40.80 ± 54.09 months. Arthritis (67.24%) was the main reason for consultation, followed by joint pain (31.38%). rheumatoid arthritis (41.03%), unclassified chronic inflammatory rheumatic diseases (38.62%), spondyloarthropathies (15.17%) and systemic lupus erythematosus (2.41%) were the major clinical forms. The immunological tests performed in 13.79% of cases were positive in 52.94% of cases. Carpitis (57.55%) and diffuse osteoporosis (45.28%) were the commonest radiographic features of the hands. 289 patients (99.66%) received symptomatic treatments such as NSAIDs (73.36%) and corticosteroids (51.90%) and 90 patients (31.03%) were treated with synthetic DMARDs such as methotrexate (88.89%). The outcome was favorable in 27.93% of cases. Conclusion: Chronic inflammatory rheumatic diseases are common diseases in rheumatological practice in Togo that deserve special attention. The establishment of a specialized immunology laboratory could be very useful for the diagnosis and early management of these diseases.