{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:28:17Z","timestamp":1787315297640,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T00:00:00Z","timestamp":1728432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ACR Open Rheumatology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We surveyed African physicians about challenges in diagnosis and management of systemic lupus erythematosus (SLE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used a cross\u2010sectional, online questionnaire\u2013based survey of African specialist physicians on availability of laboratory tests, medications, and specialized services for the diagnosis of SLE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Our 226 respondents from 31 countries were dermatologists (38%), rheumatologists (28%), and nephrologists (23%), the majority practicing at university\/state\u2010funded hospitals (80.8%), but over half of patients (59.6%) were self\u2010funded for laboratory tests and medications. Antinuclear antibody (ANA), antiphospholipid antibody, and complement tests were available to 79.4%, 67.6%, and 62.3% of respondents, respectively, but fewer in the East and West African regions. Median turnaround time for the ANA test was within two weeks but more than four weeks for 5.6% of respondents, and longer in West Africa compared with other regions (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.0002). Availability of urine protein\u2010to\u2010creatinine test, skin and renal histopathology was 82%, 82.5%, and 76.2%, respectively. Median turnaround times were within one to two weeks, but more than four weeks for 13.8% of respondents for skin histology results and usually within four weeks but more than four weeks for 24.5% of respondents for renal histology. Glucocorticoids and antimalarials were readily available across all regions, with variable availability of immunosuppressants from 93.7% for methotrexate to 65% for calcineurin inhibitors and only 58.4% for the biologic rituximab. Intensive care units\/high care facilities, hemodialysis, and renal transplantation were available to 69.8%, 91.9%, and 56.5% of respondents, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Variable availability of laboratory tests, medications, and supportive services coupled with cost constraints are major impediments to early diagnosis and optimal management of SLE in most of Africa and are likely factors contributing to underreporting and poor prognosis of SLE in Africa.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr2.11749","type":"journal-article","created":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T07:55:44Z","timestamp":1728460544000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Challenges in Diagnosis and Management of\n                    <scp>SLE<\/scp>\n                    in Africa: An Online Survey"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2710-899X","authenticated-orcid":false,"given":"Farhanah","family":"Paruk","sequence":"first","affiliation":[{"name":"University of KwaZulu  Natal South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3339-5112","authenticated-orcid":false,"given":"Dzifa","family":"Dey","sequence":"additional","affiliation":[{"name":"University of Ghana, Medical School  Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anisa","family":"Mosam","sequence":"additional","affiliation":[{"name":"University of KwaZulu  Natal South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oluwaytoyin","family":"Amira Christina","sequence":"additional","affiliation":[{"name":"College of Medicine University of Lagos  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