The management of spondyloarthritis in Sub-Saharan Africa: a real world cohort from Kinshasa, Democratic Republic of the Congo

Abstract

Abstract Objectives Data on spondyloarthritis (SpA) in sub-Saharan Africa are limited. This study aimed to describe the clinical course and progression of SpA in Congolese patients treated with NSAIDs and physiotherapy, and to explore patients’ perceptions of the disease and its treatment. Methods This 24-week study involved patients recently diagnosed with SpA and starting treatment, over two years in the outpatient clinic of the University Hospital of Kinshasa. Demographic and clinical data, including BASDAI, BASFI and BASMI indices, were collected at enrolment. All patients were treated with NSAIDs and took part in physical exercise. Assessments were conducted at baseline and weeks 6, 12 and 24. A regression analysis identified factors associated with BASDAI scores >4. Results 258 patients were initially enrolled; 49% male; mean age ± SD 46.5 ± 14.5. Of these, 177 completed the study. At baseline, 63.8% had chronic inflammatory low back pain, 42.8% peripheral arthritis, 46.3% heel enthesitis and 18.1% anterior uveitis. At baseline and weeks 6, 12 and 24, median BASDAI levels were 3.1, 1.9, 0.5 and 0, and the ASDAS-CRP score declined from 2.1 at baseline to 1.1 at week 24. 37 patients (33.6%) reported a poor perception of their disease. Those with a disease duration of more than seven years had a greater psychological distress (OR: 3.30 [1.42–7.69], p = 0.006). Conclusion First-line therapy combining NSAIDs and physiotherapy with regular follow-up yielded favourable clinical outcomes in Congolese patients with SpA.