Eo Amayo

An evaluation of quality of life in ambulatory patients with systemic lupus erythematosus attending rheumatology clinic in Kenyatta National Hospital

Background and aims Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that affects the quality of life of those affected by it. The aim of this study is to document the quality of life of patients with SLE in Kenyatta National Hospital using LUPUS QOL questionnaire. Methods Patients who satisfy the ACR (America College of Rheumatology) criteria were consecutively recruited. All patients with SLE attending the clinic were included in the study. Patients were examined for the presence of malar rash, discoid rash, arthritis/athralgia, photosensitivity, CNS symptoms, serositis and oral ulcers. The patients then filled the LUPUS QOL questionnaire. The data was then analysed using SPSS version 17.0 using student t test and regression analysis. Results Sixty two patients were analysed (60 females 2 males). Mean age of the population was 37.3 years ( 14–71 years). Mean age at diagnosis was 34.5 years with mean duration of illness 1.5 years. Majority (88.7%) had arthritis/athralgia, oral ulcers (62.9%), malar rash (59.7%), photosensitivity (58.1%), serositis (32.3%), CNS symptoms (27.4%) and discoid rash (17.7%). Patients scored globally low in all domains of LUPUS QOL. Highest domain was planning 63.7 (29.3), emotional health 61.3 (26.5), burden to others 58.9 (31.2), fatigue 57.5 (30.0), pain 56.6 (29.6), physical health 54.0 (23.3), body image 47.1 (24.2) intimate relations 41.1 (38.4). Conclusions The HRQOL was low in all domains correlated with advance in age in the domains of physical health, burden to others, emotional health and fatigue.

455 PREVALENCE OF HYPERTENSION AND CARDIOVASCULAR RISK FACTORS IN ETHNIC SOMALI RESIDENTS OF NORTH EASTERN KENYA

Background: Hypertension, a major risk factor for cardiovascular disease is rapidly attaining epidemic portions in Africa and is strongly associated with urbanisation. We studied a population of Kenyans of Somali ethnicity; traditionally a semi nomadic pastoralist community but who have settled in local urban centres and thereby subject to lifestyle influences of urbanisation. This represents a unique position in the epidemiological transition. Methods: A cross-sectional community survey carried out in Garissa town, the administrative centre for North Eastern Province, with a population of 196,062. Utilising cluster sampling 2200 adults were recruited. WHO STEPS questionnaire was followed by measurement of BP; height and weight for BMI; waist and hip circumference. Non fasting blood specimens were taken for random blood sugar and total cholesterol. Results: Data for 1823 subjects, 702 males, 1121 females were complete and analysed. Mean age was 38.5 (range 18-96 years), 82% less than 50 years. Hypertension prevalence was 12.6% (95% CI 11.1–14.2%) and increased with age reaching 38.5 % in over 65years; with a 61% detection rate. Concurrent risk factors were: diabetes 3.7% (2.9–4.7); Overweight 23.9% (21.9–25.9%), Obesity 12.6% (11.2–14.3%), Abdominal obesity (WHR)20.4% (18.5–22.3%), Smoking 5.2% (4.4–6.5%) and hypercholesterolemia 16.9%(11.0–24.3%). Male sex, increasing age, diabetes and over weight were independently associated with hypertension. Discussion: Despite the young age, this unique and previously unstudied urban & semi-urban population has a high prevalence of hypertension and cardiovascular risk factors showing evidence of epidemiological transition to NCDs. There is opportunity for primary prevention.