Date of Award
3-2025
Degree Type
Dissertation
Degree Name
Master of Medicine (MMed)
First Advisor
Prof. Ahmed Sokwalla
Second Advisor
Prof. Dilraj Sokhi
Third Advisor
Dr. Jasmit Shah
Department
Internal Medicine (East Africa)
Abstract
Background
Plasma exchange (Barth et al.) and Intravenous Immunoglobulin (Barth et al.) have emerged as favored therapeutic options for autoimmune neurological conditions. Neurological conditions cause high morbidity and mortality in the sub-Saharan region. The utilization of these treatment options in Sub-Saharan Africa remains relatively unknown. We can determine the most efficient treatments with minimal cost implications by comparing the two treatment modalities in our setup.
Methods
This retrospective descriptive chart review took place at Aga Khan University Hospital. It encompassed all patients admitted between 1st January 2011 and 31st December 2023 who had a neurological condition that necessitated treatment with TPE or IVIG. The study compared the use of these treatment modalities. The primary outcome measure was the treatment outcome of various neurologic conditions after TPE and IVIG. The secondary outcomes included the rate and nature of adverse events, inpatient and critical care stay duration, and the cost-benefit comparison between TPE and IVIG.
Results
The study involved a group of ninety-seven patients with a median age of 44.8 years (IQR: 35.0, 59.3), and there was a higher representation of females (53.6%). Hypertension (42.4%) and Diabetes Mellitus (35.6%) were the most frequently reported comorbidities. Statistical analysis demonstrated that patients receiving IVIG had better discharge outcomes than those treated with TPE (97.7% versus 80%; P=0.015). However, one month after discharge, no significant differences were observed (P=0.088). Although TPE resulted in more extended hospital stays and a higher rate of adverse reactions (47.1% vs. 2.2%; P< 0.001), it was associated with lower treatment costs than IVIG.
Conclusion
The study demonstrated that while IVIG may provide favorable immediate outcomes, TPE exhibits greater cost-effectiveness despite its association with prolonged recovery times and adverse events.
First Page
1
Last Page
42
Recommended Citation
Busaidy, S. S.
(2025). Comparison of the use of therapeutic plasma exchange to intravenous immunoglobulin for autoimmune neurological conditions at a Tertiary hospital in Kenya.. , 1-42.
Available at:
https://ecommons.aku.edu/etd_ke_mc_mm-intmed/58