Background/Purpose

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that affects all organs of the body.  Due to its chronicity SLE has been known to affect the quality of life (QoL) of those affected by it. There is minimal data on SLE in East Africa and especially in Kenya. The quality of life of SLE patients in this country has never been assessed.

Methods

Patients diagnosed with SLE as by the ACR criteria and confirmed by a  rheumatologist, were recruited into the study. Informed consent (assent for minors), was obtained from all participants. The patient’s demographic data and last prescription was acquired from the file.  Patients  clinical history was taken and a physical exam was then done looking for  the presence of malar rash,  discoid rash, arthritis/athralgia,  serositis and photosensitivity. These were defined as per the ACR criteria. After this the patient was given the LUPUS QOL questionnaire to fill. All the patients who attended the clinic at the study period were included in the study. Demographic variables  (age) were summarized into means/ medians

while gender, was presented using percentages. Correlation  of HRQOL and age , duration of illness and medication used was done using regression analysis.

Results

Sixty two patients were recruited into the study, 96% were female. Mean age of the  population was 37.3yrs (12.2) , ranging from 14-17 years.  All the patients had some form of education with 61% having  some form of tertiary education. Mean age at diagnosis was 34.5 yrs (12.2).                                                         

Majority of the patients (88.7%) had arthritis or athralgia. This was followed by oral ulcers at 32.3%, malar rash 59.7%, photosensitivity 58.1%, serositis 32.2%, CNS involvement 27.4% The least common clinical feature was discoid rash 17.7%.                                                    

On assessment of the HRQoL, The population scored globally poor in all the domains.  The  domain with the highest scores was planning (63.7), followed by burden to others ,(58.9), fatigue (57.5), pain (56.6), physical health (54.0), body image (47.1) and the lowest intimate relationships (41.1).

 

 

Most common drug in use was prednisone at 46(74.2%), hydroxychloroquine (HCQ)  43(69.4%), NSAIDS  34 patients (54.8),  Azathioprine (37.1%), Methotrexate  14 (22.6%), Mycofenolate Mofetil (MMF) 5(8.1%) ,CCB 7 (11.3%), cyclosporine 2(3.2).

Quality of life scores of the population were correlated with age for each domain. Positive correlation was found between Physical health (r 0.306 p= 0.016), burden to others (r=0.272 p= 0.032) and emotional health (r=0.315, p= 0.013) and advance in age.

There was found to be   no significant association  between HRQOL and the duration of illness or drugs used in all the domains.

Conclusion

This study demonstrates that patients with Lupus in Kenya have a poor quality of life. Lupus affects all aspects of their lives both physically and emotionally. In this study , older patients were found to have better quality of life when it came to physical health and emotional health. They were also found to be less affected by fatigue and thought of themselves as being less of a burden to others. The drugs used by the patients and the  duration since diagnosis did not affect their quality of life.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/an-evaluation-of-quality-of-life-of-patients-with-systemic-lupus-erythematosus-attending-rheumatology-clinic-in-kenyatta-national-hospital-nairobi-kenya/