Background: Systemic Lupus Erythematosus (SLE) is a complex autoimmune disease with significant variability in prevalence, incidence, and severity across geographic and ethnic groups, disproportionately affecting women of childbearing age and individuals of African descent. While global studies have expanded our understanding of SLE, Sub-Saharan Africa remains underrepresented in lupus research, with limited regional data and prevalence studies. Emerging evidence suggests the disease is more common in Africa than previously estimated, emphasizing the need for local cohort studies to address unique disease patterns and healthcare challenges. The lack of data in Africa hinders advocacy, awareness, and care while reducing global diversity in lupus research. Cohorts like LUMINA have advanced understanding in diverse populations, but similar efforts are scarce in Africa. This study addresses the gap and provides the first comprehensive analysis of the SLE patient cohort in Ghana.

Objectives: To explore the burden, outcomes, and unique sociodemographic and clinical characteristics of SLE in Ghana.

Methods: This was a retrospective cohort study at the Korle-Bu Teaching Hospital (KBTH), Rheumatology unit, a national referral center in Ghana. The study population consisted of 424 Lupus patients in Ghana, including adult and pediatric SLE patients meeting ACR 1997 and/or EULAR/ACR 2019 criteria with complete medical records. Chart reviews were conducted on patients’ medical files, and study-specific data sheets were designed to retrieve data. The data were analyzed using SPSS version 26.0, employing descriptive statistics for presentation.

Results: Key findings showed a female predominance (94.1%) and a median age of 31.0 years. The mean ± SD duration of disease in months was 46.37 ± 33.54. The cohort displayed diverse clinical manifestations, with musculoskeletal (76.7%), dermatological (67.9%), and renal involvement (52.6%) as the most prevalent, see Table 1. Mean erythrocyte sedimentation rate levels were reported as 62.15 mm/hr at the initial presentation, 46.07 mm/hr at six months to one year, and 44.65 mm/hr at the most recent presentation. Corresponding C-reactive protein levels were 33.85 mg/L, 32.68 mg/L, and 19.33 mg/L, respectively. Glomerular Filtration Rate consistently decreased in mean values (90.55 mL/min/1.73m², 83.57 mL/min/1.73m² and 81.13 mL/min/1.73m²) over time. Approximately 39.4% (167/424) of the patients developed lupus nephritis (LN), with the majority (74.3%) being diagnosed concurrently at the time of their initial SLE diagnosis, contributing to the observed decline in GFR. Serological markers including anti-nuclear antibodies, double-stranded DNA and extractable nuclear antigen were positive in 80.7%, %, 46.7% and 66.1% of the patients respectively. Steroids and hydroxychloroquine were prescribed in 95.0% and 87.7% of patients, respectively. Disease-modifying anti-rheumatic drugs such as azathioprine and methotrexate were frequently used, while the use of biological agents remained scarce. Survival was significantly impacted by renal disease and psychosis at disease presentation, with p-values of 0.001 and 0.000 , respectively.

Conclusion: This study enhances the understanding of SLE in Ghana, revealing similarities and distinctions with global cohorts. It underscores the critical need for African regional lupus registries to improve patient outcomes through tailored healthcare strategies.

REFERENCES: NIL.

Acknowledgements: NIL.

Disclosure of Interests: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.