Recent findings indicate that the reasons as to why there is a surge in numbers of gout and hyperuricemia in Africa include the adoption of western lifestyle, higher socio-economic status, male sex and excess alcohol consumption.
It is outlined further that the contributions are from the rising number of lifestyle diseases such as obesity, hypertension and diabetes.
A review titled: Defining gout and hyperuricemia in sub-Saharan Africa by Prof. George Oyoo and EK Genga gives details on gout in sub-Saharan Africa.
According to the review, there are many challenges Africa is facing including limited financial resources, misuse of finances, malnutrition, poor water and sanitation amongst others.
It states that the available health care resources are overburdened by the high burden of communicable diseases and the rising prevalence of non-communicable diseases therefore Rheumatic diseases are not considered a high priority by the various African governments. This is compounded by the low numbers of rheumatologists working across the continent.
The recommended numbers should be one per 100,000 people as per WHO standards. Thus, there is paucity of epidemiological data on rheumatic diseases, gout included. It is reported that gout is the 3rd most common arthritis in Africa after osteoarthritis and rheumatoid arthritis.
HIV has changed the landscape of gout with case reports of protease inhibitor associated gout. Gout is also reported as the third most common inflammatory arthritis after rheumatoid arthritis and HIV associated spondylo-arthropathy. Gout and hyperuricemia are predominantly seen in male Africans above the age of 50 years.
The male to female ratio ranges from 3.3:1 to as high as 19:15-11.Time to diagnosis is still too long. Mijinyawa recorded a mean duration of 8 years before diagnosis was made. Other studies found that it took the patients about 3-4 years before the diagnosis was made. Reasons for this delay include poor medical resources and a low index of suspicion by clinicians.