Availability of Therapies and Services for Parkinson’s Disease in Africa: A Continent-Wide Survey



Hamid E, Ayele BA, Massi DG, Ben Sassi S, Tibar H, Djonga EE, El-Sadig SM, Amer El Khedoud W, Razafimahefa J, Kouame-Assouan AE, Ben-Adji D, Lengané YTM, Musubire AK, Mohamed MH, Phiri TE, Nestor N, Alwahchi WA, Neshuku SN, Ocampo C, Sakadi F, Maidal MA, Ngwende GW, Hooker J, Okeng’o K, Charway-Felli A, Atadzhanov M, Carr J, Okubadejo NU, Shalash A.


Mov Disord. 2021 Jun 3. doi: 10.1002/mds.28669. Online ahead of print.


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. © 2021 International Parkinson and Movement Disorder Society. CI – © 2021 International Parkinson and Movement Disorder Society.

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Link/DOI: 10.1002/mds.28669