Department of Health Professions, Manchester Metropolitan University, Birley Fields Campus, Brooks Building, 53 Bonsall Street, Manchester, M15 6GX, UK.
Rheumatol Int. 2022 Dec;42(12):2097-2107. doi: 10.1007/s00296-022-05183-4. Epub 2022 Aug 25.
Systemic lupus erythematosus (SLE) may be more prevalent among most ethnic groups in the low-and-middle income countries (LMICs), still these countries are under-represented in epidemiological data on SLE. The aim of this study was to review the prevalence and incidence of SLE in LMICs and use meta-analytic techniques. The MEDLINE, CINHAL, Web of Science, Scopus and Global Index Medicus databases were searched for relevant studies published up to July of 2022. Papers selected for full-text review were included in the systematic review if they provided the prevalence or incidence of SLE in LMICs and published in English language. The reference lists of included articles were also searched for additional studies. Two individuals independently performed abstract and full-text review, data extraction, and quality assessment of the papers. The prevalence and incidence of SLE were pooled through random effects model. Pooled estimates were expressed with 95% confidence. Out of 2340 papers, 23 studies were included in the review. The mean age at diagnosis ranged from 25.5 to 45.8 years. Three studies were conducted in Argentina and Brazil, two studies in China and one study in Cuba, Colombia, Democratic Republic Congo, Ecuador, Egypt, India, Kenya, Malaysia, Mexico, Nigeria, Pakistan, Turkey, Ukraine, Venezuela, and Zimbabwe. The SLE prevalence and incidence varied from 3.2 to 159 per 100,000 and 0.3-8.7 per 100,000 persons, respectively. In a random effects meta-analysis (n = 10), the pooled prevalence of SLE was 103 (95% confidence interval [CI] - 17 to 224) per 100,000. Meta-analysis of data from 6 incidence studies revealed an incidence of 5 cases per year (95% CI 2-8) per 100,000. According to WHO regions, the pooled prevalence of American and Western Pacific regions was 300 (95% CI - 200 to 900) and 36 (95% CI 35-37) per 100,000, respectively. The pooled incidence of the American region was 10 (95%, 0-14) per 100,000 inhabitants. Systemic lupus erythematosus is a common disease with considerable variation in prevalence and incidence among the general population in LMICs. Accurate estimates of prevalence and incidence of SLE are required to put in place appropriate programmes to reduce its burden in LMICs. PROSPERO registration number: CRD: 42020197495, https://www.crd.york.ac.uk/prospero/ .
系统性红斑狼疮（SLE）在中低收入国家（LMICs）的大多数族裔中可能更为普遍，但这些国家在 SLE 流行病学数据方面的代表性仍然不足。本研究旨在回顾 LMICs 中 SLE 的患病率和发病率，并使用荟萃分析技术。检索了 MEDLINE、CINHAL、Web of Science、Scopus 和全球索引医学数据库，以获取截至 2022 年 7 月发表的相关研究。如果研究提供了 LMICs 中 SLE 的患病率或发病率，并以英文发表，则将其纳入系统评价进行全文审查。还查阅了纳入文章的参考文献列表以寻找其他研究。两名研究人员独立进行了摘要和全文审查、数据提取和论文质量评估。通过随机效应模型对 SLE 的患病率和发病率进行汇总。汇总估计值用 95%置信区间表示。在 2340 篇论文中，有 23 项研究被纳入综述。诊断时的平均年龄范围为 25.5 至 45.8 岁。三项研究在阿根廷和巴西进行，两项在中国进行，一项在古巴、哥伦比亚、刚果民主共和国、厄瓜多尔、埃及、印度、肯尼亚、马来西亚、墨西哥、尼日利亚、巴基斯坦、土耳其、乌克兰、委内瑞拉和津巴布韦进行。SLE 的患病率和发病率分别为每 10 万人 3.2 至 159 人和每 10 万人 0.3 至 8.7。在随机效应荟萃分析（n=10）中，SLE 的总患病率为每 10 万人 103（95%置信区间[CI] -17 至 224）。对 6 项发病率研究的数据进行荟萃分析显示，每 10 万人每年有 5 例（95%CI 2-8）。根据世界卫生组织区域，美洲和西太平洋地区的总患病率分别为每 10 万人 300（95%CI -200 至 900）和 36（95%CI 35-37）。美洲地区的总发病率为每 10 万人 10 人（95%CI 0-14）。系统性红斑狼疮是一种常见疾病，在 LMICs 普通人群中的患病率和发病率存在相当大的差异。需要准确估计 SLE 的患病率和发病率，以便在 LMICs 中制定适当的计划来减轻其负担。PROSPERO 注册号：CRD：42020197495，https://www.crd.york.ac.uk/prospero/ 。
