Parkinson’s Disease in Sub-Saharan Africa: A Review of Epidemiology, Genetics and Access to Care

Abstract

A low prevalence of Parkinson’s disease (PD) has been reported in the Sub-Saharan Africa (SSA) region. The genetic causes and clinical features of PD in this region have been poorly described. Very few reports have examined the availability and access to evidence-based quality care for people living with PD in this region. We reviewed all publications focusing on idiopathic PD from SSA published up to May 2016 and observed a prevalence of PD ranging from 7/100,000 in Ethiopia to 67/100,000 in Nigeria. The most recent community-based study reported a mean age at onset of 69.4 years. The infrequent occurrence of mutations in established PD genes was also observed in the region. Treatments were non-existent or at best irregular. Additionally, there is a lack of well-trained medical personnel and multidisciplinary teams in most countries in this region. Drugs for treating PD are either not available or unaffordable. Large-scale genetic and epidemiological studies are therefore needed in SSA to provide further insights into the roles of genetics and other etiological factors in the pathogenesis of PD. The quality of care also requires urgent improvement to meet the basic level of care required by PD patients.

Leucine rich repeat kinase 2 (LRRK2) GLY2019SER mutation is absent in a second cohort of Nigerian Africans with Parkinson disease

“…This study is the second report from Nigeria and—according to our knowledge- only one report is available from Ghana, one from Zambia and only a handful from South Africa (correct as at October 2018). [19] Majority of the previous studies are characterized by small sample size and mixed ancestries, particularly the South African cohorts. In addition almost all these studies used a candidate gene approach and until now no Genome Wide Association Study (GWAS) or next generation sequencing data is available.…”

Ethnic Variation in the Manifestation of Parkinson’s Disease: A Narrative Review

“…Generally, in low-middle income countries there is less access to PD medication and neurology services. In Sub-Saharan Africa there are very few neurologists and PD medications are unreliably supplied and expensive [150,151]. Studies comparing European PD patients to African PD patients conclude that patients in Africa have more severe disease but, despite this, are taking lower doses of levodopa.…”

Parkinson's Disease Research on the African Continent: Obstacles and Opportunities

“…As has been highlighted by many previous reports, genetic studies on African populations have been very limited (35,(41)(42)(43). All of the published studies and their findings are summarized in Supplementary Table 1.…”

“…However, new technologies, particularly telemedicine, have been identified as a promising area to improve access to care, especially for patients in rural communities (33). Educational campaigns and awareness efforts to tackle misconceptions as well as a multidisciplinary team care approach at the community level are anticipated to improve access and quality of care (34,35).…”