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.

Gout, Uric acid, Epidemiology, Diagnosis