Palscual & Sivera( 2007 defines gout as one of the commonest form of inflammatory arthritis in people over the age of 45 years affecting lower joints particularly the metatarsalphalangeal(MTP) joint in approximately 50% of cases. The disease results from accumulation of monosodium urate crystals into joint structures and periarticular sites forming tophi as one of the complications. It is characterized by acute attacks of a painful, swollen joint with redness of the skin over the joint. If untreated or poorly managed, it can cause disabling and poor quality of life (Pascual & Sivera 2007, Susan et al. 2011, Howard et al. 2011 Smith et al. 2011).
The prevalence of gout was higher in western countries and Australasia than in Africa. The United States of America(USA) has more than 6.1 million people with living gout and the number is expected to rise (Charles 2010,Smith et al. 2011).The rise in gout is attributed to acquired conditions for example, cytotoxic drugs, hypertension, alcohol use, obesity, myloproliferative disorders, consumption of fructose, metabolic syndromes and lifestyle habits. These conditions either change the nucleic acid or affect the elimination of uric acid by the renal system predisposing the subjects to gout (Smith et al. 2011).
Men were more affected (0.7%) than women (0.1%). This is because men have less uricosuric(protective) effect of estrogen than women who have higher estrogen levels. But after menopause, women have increased risks of developing gout when estrogen levels are depleted ( Zycowcz &Michael 2010).
Zycowcz & Michael (2010) discovered that 90% of men between the ages of 40 and 50 were diagnosed with gout in USA and black men were more affected than other races. This was attributed to genetic factors, hypertension and indiscriminate use of diuretics.
Despite of the high prevalence, gout has been sub optimally managed internationally. Neogi(2006) was convinced that one in five people with gout do not consult a doctor while one in four people with gout have received inappropriate treatment. This was due to a substantial gap in accessing knowledge about causes and management of gout, lay people perceived gout as part of punishment for previous life so seeking treatment was not a priority. Those who seek treatment become discouraged and dissatisfied with the long period of time for the treatment to take effect. As a result, most of them do not continue taking the medication. If the trend is not corrected, it will have a negative impact on the quality of lives for many people living with gout (Donovan 2009, Spencer et al. 2012).
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