Antiphospholipid syndrome in Africa: a review

Abstract

Objective: To review the extent of research findings on Antiphospholipid Syndrome (APS) across the African continent.
Data source: Published original researches and reviews were searched in English related to APS in Africa.
Study design: Only studies conducted on Africans living in Africa were reviewed. Related review articles done with main focus on the African experience of APS, its manifestations and laboratory findings were also included. Articles summarizing international consensus and background of APS were also included.
Data extraction: A PubMed search using the keywords “Antiphospholipid Syndrome” was done. This yielded 9167 results. The results were filtered in two arms. First, studies of APS in Africa were extracted. These were 63 out of which 27 relevant studies on Africans living in Africa were selected. Second, studies on international consensus and background of APS were filtered. These were 51 out of which 13 with relevant contents were selected. This brings the total selected articles to 40.
Data Synthesis: Data added and summarized.
Conclusion: The Antiphospholipid Syndrome (Hughes’ syndrome, APS) was first described in 1983 and has since been reported all over Africa. Over the years, several studies have been undertaken in Africa focused on different aspects of APS and new findings keep emerging revealing atypical manifestations and pointing to a likely under-recognition of the magnitude of APS in the causation of thromboembolic diseases and pregnancy morbidities in Africa. Recent findings repeatedly refute the old belief that many systemic autoimmune and rheumatic diseases are rare in Africa. APS, in the “primary” form and in the setting of Systemic Lupus Erythematosus (SLE) and other autoimmune diseases may not be uncommon in Africa. It is recognized that much work still needs to be done in understanding the true burden and the probable peculiarities of APS among Africans.

Key words: Antiphospholipid syndrome, Africa, Abortion, Thrombosis, Rheumatology, Systemic lupus erythematosus