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. 2021 Oct;36(10):2393-2407.
doi: 10.1002/mds.28669. Epub 2021 Jun 3.

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

Eman Hamid  1 , Biniyam A Ayele  2 , Daniel Gams Massi  3 , Samia Ben Sassi  4 , Houyam Tibar  5 , Emmanuel Epenge Djonga  6 , Sarah Misbah El-Sadig  7 , Wahiba Amer El Khedoud  8 , Julien Razafimahefa  9 , Ange Eric Kouame-Assouan  10 , Djibrilla Ben-Adji  11 , Yilédoma Thierry Modeste Lengané  12 , Abdu Kisekka Musubire  13 , Muhyadin Hassan Mohamed  14 , Tiwonge Elisa Phiri  15 , Nsengiyumva Nestor  16 , Wael Abdulgader Alwahchi  17 , Saara Ndinelago Neshuku  18 , Cassandra Ocampo  19 , Foksouna Sakadi  20 , Moulid Ali Maidal  21 , Gift Wilson Ngwende  22 , Juzor Hooker  23 , Kigocha Okeng'o  24 , Augustina Charway-Felli  25 , Masharip Atadzhanov  26 , Jonathan Carr  27 , Njideka U Okubadejo  28 , Ali Shalash
Affiliations

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

Eman Hamid et al. Mov Disord. 2021 Oct.

Abstract

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.

Keywords: Africa; Parkinson's disease; affordability; availability; therapies.

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