A prospective analysis of patients with rheumatic diseases attending referral hospitals in Harare, Zimbabwe.

In a 10-month prospective study a research assistant identified 411 patients with rheumatic disease at the 2 referral hospitals in Harare. Rheumatic disease accounted for less than 1% of hospital admissions. Rheumatoid arthritis, the commonest condition, accounted for 18% of patients, many of whom had impaired functional capacity. Septic arthritis (16%) was common in younger patients, often affecting the hip or knee and often associated with other complications of disseminated staphylococcal infection. Osteoarthritis (9%), rheumatic fever (7%), gout (6%), human immunodeficiency virus associated musculoskeletal problems (6%) and systemic lupus erythematosus (5%) were relatively common while the spondyloarthropathies occurred less frequently. The spectrum of rheumatic disease seen in teaching hospitals in Harare, although significantly different from that seen in Europe and North America, approximates the pattern seen in developed countries more closely than previous studies from Africa would suggest.