Knowledge and Diagnostic Practices of General Practitioners Regarding Systemic Autoimmune Diseases in Senegal: A Multicentre Cross-Sectional Study

Introduction: Systemic autoimmune diseases are chronic conditions whose prognosis largely depends on early diagnosis and specialist management. General practitioners (GPs), who are often the first point of contact for patients, play a key role in the recognition and referral of patients. However, data on GPs’ knowledge and practices remain limited in sub-Saharan Africa. This study aimed to assess the knowledge and diagnostic practices of Senegalese GPs regarding these diseases. Methods: We conducted a multicentre cross-sectional study from January 2022 to November 2023 among GPs working in 20 public and private healthcare facilities in Dakar, Thiès, and Saint-Louis. Data were collected face-to-face using an investigator-developed questionnaire assessing self-reported awareness of the main systemic autoimmune diseases, investigations requested when such diseases were suspected, specialist referral practices, therapeutic practices, and continuing medical education needs. Results: A total of 300 GPs were surveyed. The mean age was 27 years, 61% were men, and 71.6% were younger than 30 years. Systemic lupus erythematosus (96%) and rheumatoid arthritis (77%) were the diseases most frequently reported as known, followed by systemic sclerosis (66%) and Sj？gren syndrome (66%). The manifestations most frequently considered suggestive of a systemic autoimmune disease were skin lesions (93.2%), joint manifestations (74.3%), sicca symptoms (67.6%), and Raynaud phenomenon (50%). When systemic lupus erythematosus was suspected, 75.4% prescribed anti-double-stranded DNA antibodies, and 59.2% antinuclear antibodies. When rheumatoid arthritis was suspected, 88.5% prescribed rheumatoid factor, compared with 28.9% who requested anti-cyclic citrullinated peptide antibodies. Most GPs (91%) reported referral to a specialist, mainly internal medicine (43.28%) and rheumatology (40.3%). Although 68.9% considered their undergraduate education satisfactory, 80% had never received continuing medical education on these diseases, and 81% expressed interest in such training. Conclusion: This study highlights heterogeneity in the self-reported awareness and diagnostic practices of Senegalese GPs regarding systemic autoimmune diseases. Strengthening undergraduate and continuing medical education, together with closer collaboration between GPs and specialists, could facilitate earlier diagnosis and improve patient care pathways.