Low back pain in hospital outpatients in Lomé (Togo).
OBJECTIVE
To determine the patterns of low back pain and the conditions associated with this symptom in outpatients attending the rheumatology unit of the Lomé Teaching Hospital.


METHODS
Medical records of patients seen over a ten-year period were studied retrospectively.


RESULTS
Among the 9,065 patients seen during the study period, 3,204 (35.34%; 1,850 women and 1,354 men) had low back pain. Mean age at onset was 41 years, and mean duration of low back pain was three years. Diseases associated with low back pain were as follows: degenerative spinal disease, N = 3,054 (95.32%); spinal infections, N = 79 (2.47%); spondyloarthropathies, N = 44 (1.37%); and tumors, N = 27 (0.84%). The patterns of degenerative spinal disease included low back pain (N = 1,535, 47.91%), low back pain with nerve root pain suggestive of disk herniation (N = 1,108, 34.58%), and low back pain with nerve root pain and claudication suggestive of lumbar spinal stenosis (N = 411, 12.83%). Schöber's index was abnormal in 831 of the 1,408 patients (59%) with acute pain or disk herniation. Most patients with lumbar spinal stenosis were women (72.26%) and were aged 35 to 64 years. Findings suggestive of tuberculosis were present in 62 of the 79 patients with lumbar spinal infection. Among the 44 patients with spondyloarthropathies, 15 had ankylosing spondylitis and 11 had infection with the human immunodeficiency virus (HIV). Multiple myeloma was present in ten patients and metastatic tumors in eight.


CONCLUSIONS
Low back pain seems to be as common in sub-Saharan Africa as in occidental countries, with a prevalence of one-third among rheumatology outpatients. Lumbar spinal stenosis seems more common than in the occident and is mainly observed in woman. Schöber's index is not useful for measuring forward bending of the lumbar spine in Africans. The epidemiology of spondyloarthropathies in sub-Saharan Africa has been changed by the expanding HIV epidemic, despite the low prevalence of the HLA B27 phenotype.
Mijiyawa
M
M
Service de rhumatologie, CHU-Tokoin de Lomé, Togo. mijiyawa@syfed.tg.refer.org
Oniankitan
O
O
Kolani
B
B
Koriko
T
T
D000328:Adult; D000367:Age Factors; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000453:epidemiology*; D008297:Male; D010045:Outpatients / Q000706:statistics & numerical data*; D012737:Sex Factors; D013122:Spinal Diseases / Q000453:epidemiology; D014037:Togo / Q000453:epidemiology