General Practitioners' Knowledge On The Diagnosis and Management of Gout and Hyperuricemia in Northern Nigeria: A Cross-sectional online Survey

Abstract

Background: Gout is a common inflammatory arthritis; however, gaps in general practitioners' (GPs) knowledge and confidence regarding its diagnosis and management remain a concern. This study assessed the knowledge, clinical practices, and confidence of GPs in managing gout in Northern Nigeria.

Methods: A cross-sectional online survey was conducted between 2nd and 11th September, 2022, among 101 GPs recruited by purposive sampling from 19 states across three geopolitical zones in Northern Nigeria. A self-administered questionnaire, developed using standard gout classification and management guidelines, was pretested and reviewed by rheumatology experts to ensure content validity. The survey was distributed via Nigerian Medical Association WhatsApp platforms, and data were analysed using SPSS version 21.

Results: The mean (SD) age of respondents was 39.0 (8.2) years, with 75.2% practicing in tertiary health facilities. Most participants (89.1%) had previously diagnosed gout, predominantly based on hyperuricemia (85.6%), while 42.6% reported using joint aspiration. Hyperuricemia was considered synonymous with gout by 13.9% of respondents and essential for diagnosis by 58.4%. Approximately 80% did not recognise fever, low-dose aspirin, or urate-lowering therapy as gout precipitants. Allopurinol was prescribed for acute gout by 69.3%, whereas 20.8% used colchicine. Only 19.8% had received continuing medical education (CME) on gout. Confidence levels were low: 5.1% for diagnosis, 6.1% for acute management, and 7.1% for hyperuricemia management.

Conclusion: General practitioners in Northern Nigeria exhibit gaps in gout-related knowledge and clinical practice as well as low confidence with its management. Regular CME programs are needed to improve guideline-based management and patient outcomes.