Background This was the first systematic review and meta-analysis on the epidemiology of systemic lupus erythematosus (SLE) among Black Africans living in Africa.

Methods We queried PubMed, EMBASE, Web of Science, African Journals Online, and Global Index Medicus to select studies published in the period 01/01/2008–7/10/2018, and addressing SLE among Black Africans living in Africa. Results were pooled through narrative review and random-effects model, and the review protocol was registered with PROSPERO (CRD42019139226).

Results Of 1502 records, we included 15 hospital-based studies. There was no incidence data. The pooled prevalence of SLE in Rheumatology and Internal Medicine departments was 1700 per 100,000 persons (800–2900). The mean age at diagnosis ranged from 28.8 to 39.2 years, and the female proportion from 88% to 100%. The commonest SLE features were rheumatological (5.1%-99.9%), mucocutaneous (4.3%-100%) and hematological (1.4–86.9%). Patients had a high seroprevalence for anti-ribonucleoprotein 57.9% (36.4–77.9), anti-Smith 53.5% (40.4–66.2), anti-Sjogren syndrome antigen A 45.6% (19.2–73.4) and anti-Sjogren syndrome antigen B 33.7% (13.6–57.6) autoantibodies. Mean SLEDAI score (from one study) was 9.8±8.6. There was no measure of damage accrual. The pooled mortality rate was 10.3% (3.3–20.6), and main death causes were infections, kidney and central nervous system involvement.

Conclusions Over the last three decades, the epidemiology of SLE among Black Africans living in Africa shared many similarities with data from Black Africans living in the diaspora.

Acknowledgements None.