Trends and Socio-demographic Distribution of Immunological Diseases in Saint Vincent and the Grenadines

Background: More than 100 human diseases are due at least in part to an inappropriate immune system response that results in damage to an individual’s organs, tissues, or cells. Immunological diseases can affect any part of the body, and have myriad clinical manifestations that can be difficult to diagnose. At the same time, immunological diseases share many features related to their onset and progression. In addition, overlapping genetic traits enhance susceptibility to many of the diseases, so that a patient may suffer from more than one immunological disorder, or multiple immunological diseases may occur in the same family.

Aim: The study aims is to explore the trends and Socio-demographic distribution of Immunological diseases in Saint Vincent and the Grenadines from 2014-2018 in Milton Cato Memorial Hospital Saint Vincent and the Grenadines, including temporal trends and variations in age and sex from 2014 to 2018 by using routinely collected administrative health data/patient records.

Methods: From 2014 to 2018, individuals with immunological diseases were identified from the hospital records of Milton Cato Memorial Hospital, which records information on all patient coming in for healthcare services. A structured data extraction tool was employed to extract the data from the hospital record using the open data kit (ODK). Data was analysed using Statistical Package for Social Sciences (SPSS) version 23 and R Studio statistical software for analysis. The Chi-square test was used to test for association. All statistical tests were two-tailed and Level of Confidence was set at 95%, and P values < 0.05 was considered to be statistically significant.

Results: The mean age of patient with SLE was 35.65 ± 21.16 yrs. old and the median Age was 34 years old, almost two-third 218(62.6%) were females. Yearly, women showed a significantly higher incidence of immunological disease than men except in 2017 where the incidence for males were slightly higher than that of the females, there was an annual decrease in the incidence from 2014 to 2018, with a peak incidence in 2016 (0.94/1000 person-years). The lowest incidence was noted in 2018 (0.17/1000 person-years). Among sex, there was an annual decrease in the incidence from 2014 to 2018, with a peak incidence in 2014 for male (0.71/1000 person-years) and in 2016 for females (1.34/1000 person-years). The lowest incidence was noted in 2018 (0.14/1000 person-years) and (0.20/1000 person-years) for both male and female respectively.

Conclusions: The study showed that the incidence of immunological disease, Type 1 diabetes Mellitus Myopathy/Myositis and SLE in Saint Vincent have decreased in the last decade, whereas the mortality rates of both SLE and Type 1 Diabetes Mellitus have increased. This finding of increased mortality of SLE and T1D suggests that this disease is no longer rare and will have implications for future healthcare planning. Age and sex were found to be risk factors for SLE. Our data confirmed the known predilection of SLE in women. The peak age of diagnosis is middle age, contrary to the generally held belief that lupus mainly targets young people.