Prevalence of Hidradenitis Suppurativa in Durban, KwaZulu-Natal South Africa

Introduction: Hidradenitis suppurativa (HS) is a chronic, debilitating condition that is underrecognized and poorly managed in South Africa. Hence, this study aimed to determine the prevalence of HS in KwaZulu-Natal, South Africa. Methods: This multicenter, explorative, cross-sectional, and descriptive study was conducted on 500 persons accompanied by patients in a tertiary and private hospital in Ethekwini, KZN, South Africa, from 6th February to 16th March 2023. After obtaining consent, they were screened by a physician for HS on a validated questionnaire comprising questions for the presence of recurrent painful deep-seated boils in the axillae, breasts, groins, or perineum. Screened positive and selected (10%) negative persons were re-examined by a dermatologist. Relevant data on demographics, smoking, and body mass index (BMI) were also collected. Results: From 500 participants, 9 were confirmed as HS and the point prevalence was 1.8%. The HS group comprised 8 females and 1 male, with a median interquartile range age of 36 years (IQR 29-42) and BMI of 27.3 kg/m2 (IQR 26.8-29.9). Four HS patients were of African ethnic origin (44.4%), and 5 were of Asian ethnic origin (55.6%). The majority of HS cases were graded as Hurley stage I (7/9 cases) and 2 were Hurley stage III. The sensitivity from the HS questionnaire was 100% and the specificity was 80%. The positive predictive value was 0.4 while the negative predictive value was 1.0. Conclusion: The prevalence of HS in KwaZulu-Natal South Africa is 1.8%, with those of African and Indian ethnicity being more predisposed.