Prevalence of fibromyalgia at the medical out patient clinic Kenyatta National Hospital

Abstract

BACKGROUND Fibromyalgia syndrome is a disorder that is associated with significant morbidity. Despite its existence worldwide there is hardly any epidemiological data in Africa and none in Kenya. The prevalence of this disorder in the Kenyatta National Hospital medical out-patient and rheumatology clinics is unknown. OBJECTIVE: To determine the prevalence of fibromyalgia, chronic regional pain and chronic widespread pain in patients attending the medical outpatient and rheumatology clinic at Kenyatta National Hospital ; to investigate the frequency of fibromyalgia symptoms and to document the primary diagnosis and cormobid conditions in the these patients. STUDY DESIGN: This is a cross -sectional descriptive study that was carried out in the medical outpatient and rheumatology clinic at the Kenyatta National Hospital. MATERIALS AND METHODS: A questionnaire that includes the 1990 American college of rheumatology (ACR ) criteria for diagnosis of widespread pain and fibromyalgia and the Revised fibromyalgia impact questionaire (FIQR) was administered on 384 patients with musculoskeletal pain .Consecutive sampling was used. RESULTS The prevalence of fibromyalgia, chronic regional pain and chronic widespread pain amongst patients with chronic musculoskeletal pains (n = 384) in the medical outpatient clinic and rheumatology clinic of Kenyatta National Hospital was 13% (n = 50), 76% (n = 291) and 11% (n = 43) respectively. The overall three month prevalence of fibromyalgia in the general medical outpatient clinic was 1% ,Chronic widespread pains 1.2% and Chronic regional pain 6.7% .The mean age of patients with fibromyalgia was 48.5 yrs SD 2.6 [95%CI 43.1-53.8]. There was a female predominance of 97.7% (n = 42). Mean duration of illness was 5.8 years SD 0.8 [95%CI 4.1 - 7.4]. Rheumatoid arthritis was the most frequent primary (initial) diagnosis at first consultation in the clinics [30.2% (n=13/43)]. Hypertension was the commonest cormobid disease [53.5 0/0( n=23/43)]. The mean total FIQR score for fibromyalgia patients was 55.94% SD (2.85)95%CI 50.19-61.68. The most frequent symptoms were pain, fatigue, stiffness, depression, and unrefreshing sleep while balance Vll problems, headache and increased sensitivity to the environment were the least reported symptoms. CONCLUSION Fibromyalgia is prevalent amongst patients with musculoskeletal complains in the medical outpatient and rheumatology clinics at the Kenyatta National Hospital. These patients frequently have other cormobid illnesses and the primary diagnosis is often missed. Therefore there is need to sensitize the care givers on this condition