Rheumatology International

, Volume 38, Issue 9, pp 1601–1613 | Cite as

Living with systemic lupus erythematosus in the developing world

  • A. Phuti
  • M. Schneider
  • M. Tikly
  • B. Hodkinson


Most of our understanding of SLE and its negative impact originates from developed countries. This review aims to collate existing literature on Health-Related Quality of Life (HRQoL) in SLE patients living in developing countries to identify the gaps for the focus of future research. A narrative literature review was compiled using selected MeSH terms to search EBSCOHOST for articles published between January 1975 and February 2018 pertaining to HRQoL in SLE patients in developing countries. 31 studies from 11 countries were included for analysis. Only one longitudinal, one randomized controlled trial (RCT), one qualitative study, and two intervention studies were found. High disease activity and organ damage were associated with poor functional ability, mental health and low socio-economic status (SES). Poor SES is a recurring theme in developing countries, and worsens all SLE outcomes by reducing access to healthcare, mental, social and emotional support systems. In developing countries, SLE has a globally negative impact on patients’ HRQoL, similar to that seen in developed countries. There is an urgent need for more HRQoL studies, and in particular, longitudinal, qualitative and interventional studies in these countries to investigate unmet needs, and to explore novel strategies to improve patient outcomes.


Systemic lupus erythematosus Health-Related Quality of Life Developing world 



The authors acknowledge financial support from the South African National Research Fund.

Author contributions

AP, MS, MT and BH were involved in the conceptualization, planning and execution of this review. All authors contributed to data synthesis and interpretation, simultaneous draft review and the final version of the manuscript.

Compliance with ethical standards

Conflict of interest

Angel Phuti (AP), Marguerite Schneider (MS) and Mohammed Tikly (MT) received no research grants and each declare no conflict of interest. This study was funded by the National Research Fund (NRF); South Africa—Thuthuka Grant no: 443812. Bridget Hodkinson (BH) received this research grant and declares that she has no conflict of interest.

Informed consent

This narrative review includes research studies that enrolled human subjects who had individually given an informed consent.

Research involving human participants

All procedures performed in the studies (included in this review) involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Supplementary material

296_2018_4017_MOESM1_ESM.docx (14 kb)
Supplementary material 1 (DOCX 14 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Rheumatology Division, Department of MedicineJ47 Old Groote Schuur Hospital, University of Cape TownCape TownSouth Africa
  2. 2.Alan J Flisher Centre for Public Mental HealthUniversity of Cape TownCape TownSouth Africa
  3. 3.Division of Rheumatology, Department of MedicineChris Hani Baragwanath Academic Hospital, University of WitwatersrandJohannesburgSouth Africa

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