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Review
. 2024;14(3):437-449.
doi: 10.3233/JPD-230409.

Parkinson's Disease in Sub-Saharan Africa: Pesticides as a Double-Edged Sword

Sarah J Urasa  1 , Marieke C J Dekker  1 , William P Howlett  1 , Raphael J Mwezi  2 , E Ray Dorsey  3 , Bastiaan R Bloem  4
Affiliations
Review

Parkinson's Disease in Sub-Saharan Africa: Pesticides as a Double-Edged Sword

Sarah J Urasa et al. J Parkinsons Dis. 2024.

Abstract

Long-term exposure to pesticides used in agriculture is increasingly being identified as a risk factor for developing Parkinson's disease. How chronic pesticide exposure might contribute to the growth of Parkinson's disease in the mainly agricultural communities of Sub-Saharan Africa has thus far received limited attention. There are specific concerns in this area of the world: aging of the population, in combination with chronic exposure to widely used pesticides, including those that have been restricted elsewhere in the world because of neurotoxicity and other health risks. Of interest, the prevalence of Parkinson's disease among specific (semi)nomadic populations in Tanzania seems very low, possibly due to their lack of exposure to agricultural chemicals. But at the same time, pesticides have also brought important benefits to this part of the world. Specifically, in Sub-Saharan Africa, pesticides have been directly helpful in preventing and controlling famine and in containing major human infectious diseases. This creates a complex risk-benefit ratio to the use of pesticides within a global perspective, and urgently calls for the development and implementation of affordable alternatives for areas such as Sub-Saharan Africa, including non-neurotoxic compounds and non-chemical alternatives for the use of pesticides.

Keywords: Hadzabe; Maasai; Parkinson’s Disease; Sub-Saharan Africa; life expectancy; pesticides.

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Conflict of interest statement

Dr. E.R. Dorsey has received honoraria for speaking at American Academy of Neurology, American Neurological Association, Excellus BlueCross BlueShield, International Parkinson’s and Movement Disorders Society, National Multiple Sclerosis Society, Northwestern University, Physicians Education Resource, LLC, PRIME Education, LLC, Stanford University, Texas Neurological Society, and Weill Cornell; received compensation for consulting services from Abbott, Abbvie, Acadia, Acorda, Bial-Biotech Investments, Inc., Biogen, Boehringer Ingelheim, California Pacific Medical Center, Caraway Therapeutics, Curasen Therapeutics, Denali Therapeutics, Eli Lilly, Genentech/Roche, Grand Rounds, Huntington Study Group, Informa Pharma Consulting, Karger Publications, LifeSciences Consultants, MCM Education, Mediflix, Medopad, MedRhythms, Merck, Michael J. Fox Foundation, NACCME, Neurocrine, NeuroDerm, NIH, Novartis, Origent Data Sciences, Otsuka, Physician’s Education Resource, Praxis, PRIME Education, Roche, Brown, McCarthy & Gruber, Sanofi, Seminal Healthcare, Spark, Springer Healthcare, Sunovion Pharma, Theravance, Voyager and WebMD; research support from Biogen, Biosensics, Burroughs Wellcome Fund, CuraSen, Greater Rochester Health Foundation, Huntington Study Group, Michael J. Fox Foundation, National Institutes of Health, Patient-CenteredOutcomes Research Institute, Pfizer, PhotoPharmics, Safra Foundation, and Wave Life Sciences; editorial services for Karger Publications; stock in Included Health, stock in Mediflix and ownership interests in SemCap.

Prof. B.R. Bloem currently serves as co-Editor in Chief for the Journal of Parkinson’s Disease. He serves on the editorial board of Practical Neurology and Digital Biomarkers, has received honoraria from serving on the scientific advisory board for Abbvie, Biogen and UCB, has received fees for speaking at conferences from AbbVie, Zambon, Roche, GE Healthcare and Bial, and has received research support from the Netherlands Organization for Scientific Research, the Michael J Fox Foundation, UCB, Not Impossible, the Hersenstichting Nederland, the Parkinson’s Foundation, Verily Life Sciences, Horizon 2020 and the Parkinson Vereniging (all paid to the institute). Prof. BR Bloem is an Editorial Board member of this journal, but was not involved in the peer-review process of this article nor had access to any information regarding its peer review.

For the remaining authors, there are any affiliations with or financial involvement (e.g., employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, royalties) with any organization or entity with a financial interest in or in financial competition with the subject matter or materials discussed in the manuscript.

Figures

Fig. 1
Fig. 1
Pyramidal age distribution in millions population per gender projected for SSA 2050. United Nations, Department of Economic and Social Affairs, Population Division (2013). World Population Prospects: The 2012 Revision. (https://www.ageing.ox.ac.uk/population-horizons/data/gpt, Accessed October 17, 2023).
Fig. 2
Fig. 2
Total pesticide use by continent worldwide. Compared with the rest of the world, Africa’s use of pesticides is lower due to its geography with less arable land, restricted resources and smaller scale farming methods (https://www.fao.org/faostat/en/#data/RP, Accessed October 17, 2023).
Fig. 3
Fig. 3
Total pesticide use in tonnes in Africa 1990–2021. Pesticide use in SSA has tripled over the past decades. (https://www.fao.org/faostat/en/#data/RP, Accessed October 17, 2023).
Fig. 4
Fig. 4
Tanzanian farmers using pesticides (photo with permission of depicted individuals, RJ Mwezi).
Fig. 5
Fig. 5
Number of banned all-purpose pesticides per country (https://pan-international.org, Accessed October 1, 2023). EU, European Union; UK, United Kingdom; DRC, Democratic Republic of Congo; CAR, Central African Republic.
See this image and copyright information in PMC

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