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

Abstract

The burden of Parkinson's disease (PD) is becoming increasingly important in the context of an aging African population. Although PD has been extensively investigated with respect to its environmental and genetic etiology in various populations across the globe, studies on the African continent remain limited. In this Perspective article, we review some of the obstacles that are limiting research and creating barriers for future studies. We summarize what research is being done in four sub-Saharan countries and what the key elements are that are needed to take research to the next level. We note that there is large variation in neurological and genetic research capacity across the continent, and many opportunities for unexplored areas in African PD research. Only a handful of countries possess appropriate infrastructure and personnel, whereas the majority have yet to develop such capacity. Resource-constrained environments strongly determines the possibilities of performing research locally, and unidirectional export of biological samples and genetic data remains a concern. Local-regional partnerships, in collaboration with global PD consortia, should form an ethically appropriate solution, which will lead to a reduction in inequality and promote capacity building on the African continent.

Parkinson disease-associated cognitive impairment

“…251 ). However, while care inequalities in demen tia care across the globe 252,253 and research challenges in developing countries are increasingly being recognized for both PD and dementia separately 254,255 , data on the prevalence of PDassociated cognitive impairment, risk prediction, management and societal burden in these regions are lacking. Addressing these disparities with strategies to increase access to health care, research funding and public awareness on the topic is therefore mandatory and represents a global health priority.…”

Probing the Pre-diagnostic Phase of Parkinson's Disease in Population-Based Studies

“…Some initiatives have been launched to increase our understanding of PD in underrepresented areas (106)(107)(108)(109). However, for instance in Africa the conducted studies are still mainly door-to-door surveys or case-control studies (106,110,111) and populationbased cohort studies are missing (63,(106)(107)(108)(109). Studies in underrepresented areas are needed to understand variations in occurrence and phenotype of PD in different populations and to elucidate complex interactions between risk factors (4,63,104,105,107,108).…”

Parkinson’s disease – a review of pathogenesis, recent advances in management, and challenges of care in sub-Saharan Africa

“…The treatment of PD in low resource settings is often fraught with several challenges. In SSA, these include misconceptions about stigma associated with PD, manpower shortage, limited availability of medications or financial barriers to their purchase when available, very limited access to advanced therapeutics such as DBS, and limited PD research capacity [9,124,125]. The seriousness of PD-related stigma is exemplified by the fact that about one-third of participants in a survey of the South African general public attributed PD to witchcraft and nearly half thought PD patients should not live within their community [126].…”