Lupus: evidence of environmental degradation? Assessment from 60 patients followed up in the Internal Medicine Department at the Libreville University Hospital, Gabon

Med Sante Trop. 2018 May 1;28(2):165-171. doi: 10.1684/mst.2018.0798.

Abstract

Lupus is an autoimmune disease of the connective tissue that occurs predominantly in women and blacks and whose expression is influenced by environmental factors, especially ultraviolet rays. The rising temperature in Gabon for nearly two decades led us to look for correlations between the onset of lupus, the patients' regions of origin, and environmental temperatures before and at diagnosis. retrospective, descriptive, and analytic study conducted in the Department of Internal Medicine of the CHU of Libreville (Gabon), from 01/01/2016 to 31/05/2016, based on the files of patients with diagnosed lupus receiving care in the department since 01/2002. Data collection forms listed for each patients age, sex, occupation, date and season of diagnosis, and place of residence (during childhood, adolescence, and adulthood). We looked for correlations between these data and temperatures, based on meteorological data from the country's seven main weather stations over a period from 1996 to 2015. The study included 53 women and 7 men (sex ratio 0.13), with a mean age of 32.7 +/- 8.9 years. The population included students (n = 25), civil servants (n = 15), the unemployed (n = 8), private-sector employees (n = 6), and shopkeepers (n=6). Diagnoses varied according to season, with 56.6% of the cases in the dry season and 43.4% in the rainy season. From 1 to 4 cases of lupus were diagnosed annually before 2011, 7 each year from 2011 to 2014, and at least 14 per year since 2015. Most patients (62.5%) had spent their childhood, adolescence, and adulthood in the country's capital (industrial zone par excellence), 17.8% in mining regions, and 12.5% in oil-drilling areas. The increase in the number of cases of lupus appears to be correlated with their greater prevalence in regions with higher temperature exposures, that is, in industrial, mining and petroleum regions, which are the regions of greatest exposure among our lupus patients.

Keywords: Gabon; Lupus; environment; place of residence.

MeSH terms

  • Adolescent
  • Adult
  • Environmental Exposure / adverse effects
  • Female
  • Follow-Up Studies
  • Gabon / epidemiology
  • Hospital Departments
  • Hot Temperature / adverse effects
  • Humans
  • Internal Medicine
  • Lupus Erythematosus, Systemic / epidemiology*
  • Lupus Erythematosus, Systemic / etiology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Young Adult