The Southern African region faces its own lupus challenges. The low incidence rate across Africa may be the result of multiple factors. In most cases there is a delay in diagnosis, Tiffin et al reported that in 93% of cases there is a complete delay or some delay in diagnosis. Lack of awareness about SLE, limited facilities in primary healthcare settings, limited diagnostic centers to perform serological and histological tests for SLE, and availability of medical specialists are major factors across Africa. We say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an original essay Treatment of SLE in Africa is difficult due to the high cost of drugs. Tiffin and colleagues mentioned in their review of SLE patients in Africa that the cost of MMF is approximately $100 and the cost of a dialysis session is $100-150. This high cost of care is also found in developed countries. But the poor socioeconomic conditions of patients in developing countries are major contributors to the overall outcome of SLE. A review identified paucity of prevalence data, decreasing funding for rheumatology-related research, and low numbers of rheumatologists as important contributing factors. There is a low ratio of rheumatologists per population, ranging from 1:35,000 to 1:1600,000. Diagnostic delay occurs if laboratory facilities to perform serological testing, urinalysis and tissue biopsy facilities are not available. Renal complications such as lupus nephritis are a poor prognostic indicator of SLE and require early diagnosis. Renal biopsy is the gold standard investigation for lupus nephritis. These services are not available in many centers in southern Africa. Delay in diagnosis leads to a more unfavorable outcome. Antinuclear antibody (ANA) testing facility is available in most Southern African countries. Follow-up of SLE treatment is a major concern to avoid complications. Lack of laboratory facilities at primary, secondary and tertiary hospital levels has a negative impact on the outcome of a patient treated as SLE. It is important to monitor treatment-related toxicity. Tazi Mahek et al mentioned in their review that patient treated with MMF has fewer treatment-related infections and hospital admissions compared to CYC. Biological immunosuppressive treatment requires preventive screening for tuberculosis. Even the HIV patient with low CD4 requires treatment adjustment to avoid opportunistic infections. A limited number of rheumatologists may compromise the early initiation of appropriate therapy. Standard clinical guidelines are modified in developing countries due to drug costs and availability. There are some universal problems in the management of SLE. This problem includes complication of medications; adhesion and drug-drug interaction due to other diseases represent a challenge in the management of lupus. Poor patient adherence also contributes to their poor outcome. Tazi Mahek et al in their review of a study in Brazil mentioned that 51% of non-adherence among SLE patients was due to financial reasons. Please note: this is just an example. Get a custom paper from our expert writers now. Get a Custom Essay The understanding of complex diseases like SLE is changing over the years. The methods of treatment and diagnosis will be more..