Date of Award
3-2025
Degree Type
Dissertation
Degree Name
Master of Medicine (MMed)
First Advisor
Prof. Dilraj S. Sokhi
Second Advisor
Dr. Jasmit Shah
Third Advisor
Prof. Thomas M. Jenkins
Department
Internal Medicine (East Africa)
Abstract
Introduction: Motor Neurone Disease (MND) is a rare, disabling and incurable illness marked by relentless degeneration of motor neurons with loss of voluntary motor function and eventual death. In the West, patient demographics and clinical characteristics are well documented. Available African research is mostly for North, West and South Africa with a knowledge gap existing on the East African illness. This study characterized MND phenotype in a Kenyan population.
Objectives: To describe the clinical phenotype and outcomes of MND in a Kenyan hospital-based population.
Methods: The medical charts of all adult MND patients assessed at AKUHN between January 2010 to December 2023 were retrospectively reviewed. The biographical data and clinical features of these patients were captured from their electronic and manual health records and statistical analysis performed.
Results: In total, 160 patients had their data analyzed. The male to female ratio was 1.76:1. The median age at presentation was 55.0 (IQR: 45.0 – 68.0) years. The site of first symptom onset was the lower limbs in 35.4% and the bulbar region in 34.0%. Notably, 59% of the patients were not tested for HIV and amongst those tested, 13.9% were HIV positive on ART. Majority (56.7%) received Riluzole. Due to high rates of loss to follow up, outcome data were incomplete and hence not analyzed.
Conclusion: A significantly higher percentage (34.0%, 95% CI [26.4-42.5%]) of patients had bulbar onset MND compared to what is reported in most of Africa. This supports the geographic variation in MND presentation. More than half (59%) were not tested for HIV despite 13.9% positivity amongst those tested and majority (56.7%) received Riluzole. The secondary objective of describing clinical outcomes was not fulfilled.
Recommendations: Further genetic research to investigate the noted considerable proportion of bulbar onset MND as well as to inform more targeted treatment options.
First Page
1
Last Page
40
Recommended Citation
Kamadi, E. N.
(2025). The clinical phenotype of motor neurone disease in a Kenyan hospital – based population. , 1-40.
Available at:
https://ecommons.aku.edu/etd_ke_mc_mm-intmed/56