Clinical management and disease-modifying treatment for amyotrophic lateral sclerosis in African hospital centers: the TROPALS study.

Journal: Amyotrophic lateral sclerosis & frontotemporal degeneration

Volume: 23

Issue: 3-4

Year of Publication: 2022

Affiliated Institutions:  INSERM, Univ. Limoges, CHU Limoges, IRD, U Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France. Laboratoire de Recherche en Neurosciences Université Benyoucef Benkhedda, Alger , Service de Neurologie CHU Mustapha, Algérie. Department of Neurology, LRSP, Clinical Investigation Center of Neurosciences and Mental Health , Universitary Hospital Razi-Mannouba, Tunis, Tunisia, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia. Division of Neurology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa. Neurology Department, CHNU Fann, UCAD, Dakar, Senegal. Neurology Department, CHU Campus Université de Lomé. Faculty of Health Sciences, Laboratory of Chronic and Neurologic Diseases Epidemiology, University of Abomey-Calavi, Cotonou, Bénin; Neurology Unit, CNHU Cotonou, Cotonou, Bénin. Université de Lomé, Togo.

Abstract summary 

To assess the availability of health workers and medications for clinical management of amyotrophic lateral sclerosis (ALS) in African hospital centers. Availability and affordability analyses of disease-modifying treatments were performed. : A multicenter observational study involving African hospitals was conducted. A standard questionnaire was developed based on the European Federation of the Neurological Societies (EFNS) guidelines. We collected data on multidisciplinary care and availability of medicines. The availability and affordability were evaluated according to the WHO guidelines. : Nine hospital centers from eight African countries participated. We observed a low degree of implementation of multidisciplinary care in ALS management. Riluzole was only available in centers from South Africa, Senegal, Tunisia, and Togo. This treatment was unaffordable and the adjusted price was highly variable among countries. The cost of riluzole was partly or fully covered by patients, which implies a substantial economic burden. : Our findings strengthen the need to promote multidisciplinary care in the clinical management of ALS in Africa. Disease-modifying medication should be both available and affordable. Local and international collaboration is needed to improve ALS health care access in Africa.

Authors & Co-authors:  Luna Jost Diagana Ait Aissa Tazir Ali Pacha Kacem Gouider Henning Basse Cisse Balogou Kombate Agbetou Houinato Gnonlonfoun Millogo Agba Belo Sengxeu Hamidou Preux Benoit Couratier

Study Outcome 

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Citations : 
Authors :  25
Identifiers
Doi : 10.1080/21678421.2021.1961806
SSN : 2167-9223
Study Population
Male,Female
Mesh Terms
Amyotrophic Lateral Sclerosis
Other Terms
Africa;Amyotrophic lateral sclerosis;affordability;availability;management;riluzole
Study Design
Study Approach
Country of Study
Togo
Publication Country
England