Availability of Therapies and Services for Parkinson's Disease in Africa: A Continent-Wide Survey
Internal Medicine (East Africa)
Background: The growing burden of Parkinson's disease (PD) in Africa necessitates the identification of available therapies and services to improve patient care.
Objective: To investigate the availability, affordability, frequency of usage, and insurance coverage of PD therapies (pharmacological, surgical, physical, and speech therapies) and services including specialized clinics, specialists, and nurses across Africa.
Methods: A comprehensive web-based survey was constructed and distributed to neurologists/physicians with a special interest in PD across Africa. The survey instrument includes components that address availability, affordability, frequency of use, and insurance coverage of different therapies and services.
Results: Responses were received from 28 (of 43 contacted) countries. Levodopa-based oral preparations were always available in 13 countries (46.4%) with variable affordability and “partial or no” insurance coverage in 60% of countries. Bromocriptine was the most available (50%) and affordable ergot dopamine agonists (DA), whereas non-ergot DA was always available in only six countries (21.4%). Trihexyphenidyl was the most available and affordable anticholinergic drug (46.4%). Tricyclic antidepressants and selective serotonin reuptake inhibitors were available in most countries (89.3% and 85.7% respectively), with variable affordability. Quetiapine and clozapine were less available. Specialized clinics and nurses were available in 25% and 7.1% of countries surveyed, respectively. Other services were largely unavailable in the countries surveyed.
Conclusion: PD-specific therapies and services are largely unavailable and unaffordable in most African countries. The data provide a platform for organizing strategies to initiate or scale up existing services and drive policies aimed at improving access to care and tailoring education programs in Africa.
Publication ( Name of Journal)
Ayele, B. A.,
Massi, D. G.,
Sassi, S. B.,
Djonga, E. E.,
El-Sadig, S. M.,
KHEDOUD, W. A.,
(2021). Availability of Therapies and Services for Parkinson's Disease in Africa: A Continent-Wide Survey. Movement Disorders, 36(10), 2393-2407.
Available at: https://ecommons.aku.edu/eastafrica_fhs_mc_intern_med/247