The Knee May Be the Preferred Localization of Gout in Sub-Saharan Africa: An Hospital Retrospective Analysis With Literature Review

Le Genou Serait la Localisation Préférentielle de la Goutte en Afrique Subsaharienne : Une Analyse Rétrospective Hospitalière avec Revue de la Littérature

Authors

  • Fernando Kemta Lekpa 1. Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Cameroon
  • Sylvain Raoul Simeni Njonnou 1. Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Cameroon
  • Baudelaire Fojo Talongong 4. Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon
  • Abdoul Salam Hamadama 1. Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Cameroon
  • Paul Eloundou 5. Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon
  • Christian Ngongang Ouankou 1. Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Cameroon
  • Francine Same Bebey 4. Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon
  • Henry Namme Luma 1. Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Cameroon
  • Madeleine Ngandeu-Singwe 4. Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon
  • Siméon Pierre Choukem 1. Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Cameroon

Keywords:

Gout, Knee, Cameroon, Preferential location

Abstract

RESUME
Introduction. De nombreuses publications en Afrique subsaharienne remettent en question la place prépondérante occupée par l’arthrite de la première métatarso-phalangienne (MTP1) ou podagre dans le diagnostic de la goutte. C’est ainsi que nous avons réalisé cette étude afin de déterminer l’articulation la plus touchée au moment du diagnostic de la goutte en Afrique Subsaharienne. Méthodologie. Nous avons réalisé une étude transversale des dossiers de patients vus à l’Hôpital Général de Douala, Cameroun, entre 2004 et 2014. Nous avons inclus les patients avec diagnostic de goutte (critères de l’ACR 1977). Les principales caractéristiques sociodémographiques, cliniques et biologiques des personnes présentant une goutte ont été collectées au moment du diagnostic. Résultats. Nous avons colligé 511 dossiers (415 hommes et 96 femmes). L’âge moyen était de 55,9 ± 10,8 ans. La douleur articulaire (n=508; 99,4 %) était le principal motif de consultation au moment du diagnostic. Les genoux (n=300; 62,6 %), les chevilles (n=187; 39,0 %), et les MTP1 (n=128; 26.7%) étaient les articulations les plus touchées. L’hypertension artérielle était la comorbidité la plus fréquemment retrouvée. L’hyperuricémie était retrouvée chez plus des trois-quarts des patients. Celle-ci s’associait à une syndrome inflammatoire biologique et des lésions d’arthropathies uratiques dans la même proportion de patients. Conclusion. Le genou est l’articulation la plus concernée par la goutte au moment du diagnostic au Cameroun, comme dans de nombreuses publications africaine. En Afrique subsaharienne, la MTP1 occupe en général la deuxième voire la troisième place parmi les articulations les plus fréquentes au moment du diagnostic de la goutte.
ABSTRACT
Introduction. Many publications in sub-Saharan Africa question the predominant role of first metatarsophalangeal joint (MTP1) or gout in the diagnosis of gout. This study was conducted to determine the most affected joint at the time of gout diagnosis in sub-Saharan Africa. Methodology. We conducted a cross-sectional study of patient records seen at the Douala General Hospital, Cameroon, between 2004 and 2014. We included patients with a diagnosis of gout (ACR 1977 criteria). The main sociodemographic, clinical, and biological characteristics of individuals with gout were collected at the time of diagnosis. Results. We collected 511 records (415 men and 96 women). The mean age was 55.9 ± 10.8 years. Joint pain (n=508; 99.4 %) was the main reason for consultation at the time of diagnosis. Knees (n=300; 62.6%), ankles (n=187; 39.0%), and MTP1 (n=128; 26.7%) were the most affected joints. Hypertension was the most commonly found comorbidity. Hyperuricemia was found in over three-quarters of patients. This was associated with biological inflammatory syndrome and urate arthropathy lesions in the same proportion of patients. Conclusion. The knee is the joint most affected by gout at the time of diagnosis in Cameroon, as in many African publications. In sub-Saharan Africa, the MTP1 generally ranks second or third among the most common joints at the time of gout diagnosis.

References

Dalbeth N, Gosling AL, Gaffo A, Abhishek A. Gout. Lancet. 2021 May 15;397(10287):1843-1855. doi: 10.1016/S0140-6736(21)00569-9. Epub 2021 Mar 30. Erratum in: Lancet. 2021 May 15;397(10287):1808.

Scuiller A, Pascart T, Bernard A, Oehler E. La maladie goutteuse [Gout]. Rev Med Interne. 2020 Jun;41(6):396-403.

Doualla-Bija M, Lobe Batchama Y, Moutchia-Suh J, Ama Moor VJ, Kamdem F, Lekpa FK, Luma Namme H. Prevalence and characteristics of metabolic syndrome in gout patients in a hospital setting in sub-Saharan Africa. Diabetes Metab Syndr. 2018 Nov;12(6):1007-1011. doi: 10.1016/j.dsx.2018.06.015. Epub 2018 Jun 28.

Lekpa FK, Bebey FS, Bouallo I, Njonnou SRS, Luma HN, Singwe-Ngandeu M, Choukem SP. Gender difference in the association between gout at diagnosis and metabolic syndrome in African population: a retrospective cohort study. Pan Afr Med J. 2022 Dec 1;43:164. doi: 10.11604/pamj.2022.43.164.37197.

Nuki G, Simkin PA. A concise history of gout and hyperuricemia and their treatment. Arthritis Res Ther. 2006;8 Suppl 1(Suppl 1):S1.

Taylor WJ, Fransen J, Jansen TL, et al. Study for Updated Gout Classification Criteria: Identification of Features to Classify Gout. Arthritis Care Res (Hoboken). 2015;67(9):1304-1315.

Stewart S, Dalbeth N, Vandal AC, Rome K. The first metatarsophalangeal joint in gout : a systematic review and meta-analysis. BMC Musculoskelet Disord. 2016 Feb 11;17:69.

Mijiyawa M. Gout in patients attending the rheumatology unit of Lomé Hospital. Br J Rheumatol. 1995 Sep;34(9):843-6.

Lekpa FK, Doualla M, Luma HN. THU0425 The first metatarsophalangeal joint (MTP1) is not the main localization of gout at diagnosis in sub-saharan africa. Annals of the Rheumatic Diseases 2017;76:368.

Wallace SL, Robinsom H, Masi AT, Decker JL, McCarty DL, Yu FT. Preliminary criteria for the classification of the acute arthritis of primary gout. Arthritis Rheum. 1977;20(3): 895-900.

Zabsonre Tiendrebeogo WJ, Kakpovi K, Kabore F, Bognounou R, Kambou/Tiemtore B, Dayambo C, Drabo YJ, Ouedraogo DD. Aspects épidémiologiques et diagnostiques de la goutte en milieu hospitalier à Ouagadougou. Médecine d'Afrique Noire. 2017 Oct;6410 :471-6.

Missounga L, Mouendou-Mouloungui EG, Iba-Ba J, Nseng-Nseng-Ondo IR, Nziengui-Madjinou MIC, Mwenpindi-Malékou D, Moussavou-Kombila JB, oguikouma JB. Croyances et représentations des patients atteints de polyarthrite rhumatoïde et de la goutte : le « fusil nocturne ». Rev Rhum. 2018 May ;85(3) : 251-254.

Lutalo SK. Gout: an experience from Zimbabwe. Cent Afr J Med. 1993 Mar;39(3):60-2. PMID: 8306386.

Singwé-Ngandeu M, Nouédoui C, Sobngwi E, Matike M, Juimo AG. La goutte en consultation hospitalière à l’Hôpital Central de Yaoundé. Mali Medical. 2009;XXIV(4):17-20.

Adelowo O, Umar A, Oguntona SA. Gouty arthritis in Nigerians: clinical and laboratory correlates. Afr J Rheumatol 2014;2(1):23-8.

Jean-Mermoze DK, Mariam G, Mohamed D, Marina O, Kawélé CA, Aboubakar B, Baly O, Edmond E. La Goutte : Aspects Cliniques Et Paracliniques. ESJ [Internet]. 2020Jul.31 [cited 2024Apr.7];16(21):142. Available from: https://eujournal.org/index.php/esj/article/view/13175

Diomandé M, Kpami You N, Coulibaly Y, Bamba A, Sylla A, Traoré A, et al. Comorbidités au cours de la goutte à Abidjan : à propos de 91 cas observés en hospitalisation rhumatologique. Rhum Afr Franc [Internet]. 18 déc. 2022 [cité 7 avr. 2024];4(1):7-14. Disponible sur: https://www.rhumatoafrique.org/index.php/raf/article/view/40

Kodio B, Pamanta IS, Sylla C, et al. Step wise approach of gout in the Rheumatology ward of Point-G University Teaching Hospital of Bamako, Mali. African Journal of Rheumatology. 2015;3:22–26.

Barry A, Kamissoko AB, Conde K, Toure M, Traore M, Niasse N, Diallo S. La goutte en consultation hospitalière au Sénégal : à propos de 106 cas au service de rhumatologie du CHU Aristide Le Dantec de Dakar. RAFMI. 2022 ;9(1) :7-13.

Oyoo GO. Gout in patients attending a rheumatology clinic in Nairobi, Kenya, Healthline -Nairobi. 2004. [cited 2024 Apr. 07]. Available from: http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/50162

Cassim B, Mody GM, Deenadayalu VK, Hammond MG. Gout in black South Africans: a clinical and genetic study. Ann Rheum Dis. 1994 Nov;53(11):759-62.

Tikly M, Bellingan A, Lincoln D, Russell A. Risk factors for gout: a hospital-based study in urban black South Africans. Rev Rhum Engl Ed. 1998 Apr;65(4):225-31.

Gaffo AL, Schumacher HR, Saag KG, Taylor WJ, Dinnella J, Outman R, Chen L, Dalbeth N, Sivera F, Vázquez-Mellado J, Chou CT, Zeng X, Perez-Ruiz F, Kowalski SC, Goldenstein-Schainberg C, Chen L, Bardin T, Singh JA. Developing a provisional definition of flare in patients with established gout. Arthritis Rheum. 2012 May;64(5):1508-17.

Neogi T, Jansen TL, Dalbeth N, Fransen J, Schumacher HR, Berendsen D, Brown M, Choi H, Edwards NL, Janssens HJ, Lioté F, Naden RP, Nuki G, Ogdie A, Perez-Ruiz F, Saag K, Singh JA, Sundy JS, Tausche AK, Vazquez-Mellado J, Yarows SA, Taylor WJ. 2015 Gout Classification Criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheumatol. 2015 Oct;67(10):2557-68.

Nkeck JR, Singwé Ngandeu M, Ama Moor V, Nkeck JP, Chedjou JP, Ndoadoumgue AL, Mbacham WF. Genetic analysis for rs2280205 (A>G) and rs2276961 (T>C) in SLC2A9 polymorphism for the susceptibility of gout in Cameroonians: a pilot study. BMC Res Notes. 2018 Apr 3;11(1):230.

Doualla-Bija M, Lobe Batchama Y, Moutchia-Suh J, Ama Moor VJ, Kamdem F, Lekpa FK, Luma Namme H. Prevalence and characteristics of metabolic syndrome in gout patients in a hospital setting in sub-Saharan Africa. Diabetes Metab Syndr. 2018 Nov;12(6):1007-1011.

Lekpa FK, Bebey FS, Bouallo I, Njonnou SRS, Luma HN, Singwe-Ngandeu M, Choukem SP. Gender difference in the association between gout at diagnosis and metabolic syndrome in African population: a retrospective cohort study. Pan Afr Med J. 2022 Dec 1; 43:164.

Downloads

Published

26-06-2024

How to Cite

Fernando Kemta Lekpa, Sylvain Raoul Simeni Njonnou, Baudelaire Fojo Talongong, Abdoul Salam Hamadama, Paul Eloundou, Christian Ngongang Ouankou, Francine Same Bebey, Henry Namme Luma, Madeleine Ngandeu-Singwe, & Siméon Pierre Choukem. (2024). The Knee May Be the Preferred Localization of Gout in Sub-Saharan Africa: An Hospital Retrospective Analysis With Literature Review: Le Genou Serait la Localisation Préférentielle de la Goutte en Afrique Subsaharienne : Une Analyse Rétrospective Hospitalière avec Revue de la Littérature. HEALTH RESEARCH IN AFRICA, 2(7). Retrieved from http://hsd-fmsb.org/index.php/hra/article/view/5851

Issue

Section

Medicine and Surgery in the Tropics

Most read articles by the same author(s)