Building the evidence base for rheumatic and musculoskeletal disease in Africa — and training the clinicians who will carry it forward.
Rheumatology is a rapidly evolving field, with a growing set of diagnostic tools and new therapies. Clinicians in resource-constrained settings such as ours need to explore novel ways to deliver excellent clinical care to their patients, whilst advancing understanding of the pathogenesis and burden of musculoskeletal diseases affecting Africans. Excitingly, the relevance of clinical and laboratory research from the “developing world” is increasingly recognised. Studies assessing cost-effective strategies in resource-constrained settings might also provide important lessons for the recession-hit healthcare systems of many developed countries.
Young South African clinicians are frequently overwhelmed by the clinical burden of heavy patient-loads and long working hours, yet with appropriate supervision, can undertake novel and meaningful research that informs clinical practice. Hence we believe that mentorship of young health care workers is vital, so that young clinicians are attracted to academic careers. This will amend the dearth of published work and health information arising from Africa and other parts of the developing world.
Importantly, these research projects have academic impact by providing opportunities for clinicians and scientists from different disciplines to collaborate. This enriches the exploration of each disease, and offers excellent academic outcomes in terms of Master in Medicine (MMed), Master in philospophy (M Phil) and Doctor of Philosophy (PhD) degrees.
Clinicians in resource-constrained settings such as ours need to explore novel ways to deliver excellent clinical care to their patients.
Division of Rheumatology, UCT
Chronic rheumatic and musculoskeletal disorders (RMD’s) are an important and growing cause of disability and impaired quality of life in South Africans, yet there is little published work on these diseases or the impact of these diseases on patients’ lives. “Hands On” is a prospective longitudinal registry collating demographic, clinical and genetic data of patients with RMD’s. Participants are recruited from the rheumatology outpatient clinics of Groote Schuur Hospital, a tertiary academic hospital in the Western Cape, South Africa and are reviewed annually.
Anticipated outcomes
This project will provide high quality contemporary data on the burden of RMD’s in the Western Cape, South Africa.
A biobank of serum and genetic samples to analyse in future sub-studies.
This data will hopefully that will lead to development of strategies to improve clinical care and lifestyle interventions for patients with RMD’s.
This registry will serve as a platform for future interventional studies, qualitative interviews and clinical trials.
This registry will enhance the research capacity of the Department by offering employment, training and experience to the study coordinator and data capturer.
The registry will lead to post-graduate degrees for clinical researchers allowing detailed study of specific diseases, or aspects of health-related Quality of Life across diseases.
In time it is hoped that this registry will be used as a template by other academic rheumatology centres in South Africa and elsewhere in Africa. Multicentered data will allow comparison of patients across geographical regions, and will also allow analysis of uncommon manifestations.
Four decades of published work from the division and its collaborators — from bone-density and lupus studies in the late 1980s, through the African Lupus Genetics Network and global rheumatoid arthritis epidemiology, to the South African Rheumatism and Arthritis Association’s 2024 national treatment guidelines. Much of it asks how good rheumatology care can be delivered where resources are short.
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These projects offer opportunities for clinicians and scientists from different disciplines to work together, and lead to MMed, MPhil and PhD degrees. If you would like to discuss a collaboration or postgraduate supervision, get in touch with the division.