Rheumatic disorders in Zimbabwe: a prospective analysis of patients attending a rheumatic diseases clinic.

The pattern of rheumatic disease in Africa differs from that in Europe and the United States and these differences may provide clues to its cause or pathogenesis. In a six month prospective analysis of 141 patients (83 female) attending a rheumatic diseases clinic rheumatoid arthritis was the commonest disorder, occurring in 49 patients. Twenty seven of the 49 (55%) were seropositive, 25 (51%) had erosive disease with rheumatoid nodules (13/49, 27%), and extra-articular complications (6/49, 12%), indicating a pattern of disease unlike the early reports from Africa. Systemic lupus erythematosus found in 18/141 (13%), gout in 12 (9%), ankylosing spondylitis in six (4%), and Reiter's syndrome in five (4%), in contrast with their rarity in previous reports from Africa, were not uncommon, whereas tropical polyarthritis was seldom diagnosed. The pattern of rheumatic disease in Harare, a large city, is changing to approximate more closely the pattern seen in developed countries.