Main Article Content
Step wise approach of gout in the rheumatology ward of Point-G University Teaching Hospital of Bamako, Mali
Abstract
Background: Worldwide, the numbers of gout cases are increasing due to behaviour changes and socio economic factors. Although this can be a global health problem according to data reported from industrialized countries, there are limited reports on the disease burden in low and middle income countries like Mali where no data are available. Hence the study was conducted to determine the prevalence and risk factors of gout among Malian patients in a hospital setting.
Methods: This was a descriptive study conducted in the Rheumatology ward of Point-G University Teaching Hospital among out patients visited from January 1st 2009 to February 28th 2010. Using World Health Organization (WHO) step wise approach, a total of 1,143 patients visited, of whom 100 fulfilled the American College of Rheumatology (ACR 1977) criteria of gout. Patients recruited were aged 18 years and above if they provided consent. They were also followed according to the multi parametric step wise approach (step1, step2 and step3).
Results: The prevalence of gout was 17.3%. Patients’ mean (range) age was 57 years (24-75). Women were more affected than men (sex ratio of 1.2) with menopausal women the most affected group (91%). Obesity, high blood pressure, diuretics intake, and kidney failure were observed in 83%, 76%, 64% and 37%, respectively. Clinical manifestations of gout were located in joints (100%), in skin (4 cases of tophus), and kidneys (1 case of nephrolithiasis). Monoarthritis was predominant (36%), especially in the knee (92%). In addition, 95% of patients had hyperuricemia. The main comorbidities were dominated by osteoarthritis, kidney failure, diabetes, and rheumatoid arthritis with 68%, 37%, 13% and 6%, respectively.
Conclusion: The prevalence of gout in our patient was high and overweight/ obesity, high blood pressure, diuretics intake and kidney failure were frequent. High prevalence was reported among menopausal women. Although our study was limited, it provided for the first time data on the prevalence of gout and its potential risk factors in Mali. There is a suggestion for further investigation of the disease risk factors.
Key words: Gout, Step wise approach, Epidemiology, Mali
Methods: This was a descriptive study conducted in the Rheumatology ward of Point-G University Teaching Hospital among out patients visited from January 1st 2009 to February 28th 2010. Using World Health Organization (WHO) step wise approach, a total of 1,143 patients visited, of whom 100 fulfilled the American College of Rheumatology (ACR 1977) criteria of gout. Patients recruited were aged 18 years and above if they provided consent. They were also followed according to the multi parametric step wise approach (step1, step2 and step3).
Results: The prevalence of gout was 17.3%. Patients’ mean (range) age was 57 years (24-75). Women were more affected than men (sex ratio of 1.2) with menopausal women the most affected group (91%). Obesity, high blood pressure, diuretics intake, and kidney failure were observed in 83%, 76%, 64% and 37%, respectively. Clinical manifestations of gout were located in joints (100%), in skin (4 cases of tophus), and kidneys (1 case of nephrolithiasis). Monoarthritis was predominant (36%), especially in the knee (92%). In addition, 95% of patients had hyperuricemia. The main comorbidities were dominated by osteoarthritis, kidney failure, diabetes, and rheumatoid arthritis with 68%, 37%, 13% and 6%, respectively.
Conclusion: The prevalence of gout in our patient was high and overweight/ obesity, high blood pressure, diuretics intake and kidney failure were frequent. High prevalence was reported among menopausal women. Although our study was limited, it provided for the first time data on the prevalence of gout and its potential risk factors in Mali. There is a suggestion for further investigation of the disease risk factors.
Key words: Gout, Step wise approach, Epidemiology, Mali
