Living with systemic lupus erythematosus in the developing world

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.