ABSTRACT
BACKGROUND: The episodic nature of gout and diagnostic uncertainty in the absence of microcrystal evidence make it particularly difficult to estimate the frequency of gout. Our aim was to review the literature on the epidemiological and diagnostic aspects of gout in sub-Saharan Africa. METHODS: This literature review was conducted using the MEDLINE database (via PUBMED), Google Scholar, and conference abstracts. The selection process was based on reading the titles first, then the abstracts, and then the full texts once the articles had been selected. Studies were included in this review if they presented original findings on the epidemiological and/or diagnostic aspects of gout in sub-Saharan Africa. Two groups of two investigators independently reviewed the studies. The results were analysed descriptively. RESULTS: The literature search identified 131 articles and 22 conference abstracts. Nineteen articles were included in our review. Twelve studies were retrospective, five were cross-sectional, one was prospective, and one was both retrospective and cross-sectional. The duration of the studies ranged from 1 to 15 years, and the sample size ranged from 15 to 511 patients, for a total of 2557 patients. Gout was quite common, with a maximum frequency of 11.87%. Fourteen articles diagnosed gout via criteria, including 9 studies totaling 1174 patients via the 1977 ACR criteria. Gout tophi were reported in 15 articles involving 464 patients. Of these studies, seven looked for monosodium urate crystals in 317 (43.85%) of 723 patients. Among the 317 patients, monosodium urate crystals were detected in 263 (82.97%) patients. Eleven studies reported mean uricemia values ranging from 452.09 µmol/L to 642.44 µmol/L, with a mean of 510.63 µmol/L. CONCLUSIONS: This review revealed that all the studies conducted in sub-Saharan Africa were intrahospital studies, and the majority were retrospective. Consequently, there is a clear need for population-based studies.
ABSTRACT
This article presents the case of a young patient with severe acute left hip pain who tested positive for COVID-19. The diagnostic approach and management are presented, followed by a review of the literature. This 11-year-old student was admitted for acute left hip pain of abrupt onset, inflammatory, evolving for 24 h in a febrile context with no change in general condition. The initial workup revealed a hyperleukocytosis in the blood count, CRP 198.52 mg/L, and a 95 mm SV. The pelvic X-ray was unremarkable, and the hip ultrasound showed synovial hypertrophy, with no effusion on Doppler examination. The situation worsened 24 h later with the onset of acute respiratory distress syndrome. The chest X-ray showed bilateral alveolar interstitial lung disease, and the CT scan showed hyperdensity and crazy paving. The COVID-19 RDT test on a nasopharyngeal sample came back positive, as did the RT-PCR. Death occurred a few hours later in acute respiratory distress. Our case is consistent with what has been reported in the literature, but requires further study on an international scale to better define the phenotype of the disease.
