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

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,...

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Published in:Movement disorders 2021-10, Vol.36 (10), p.2393-2407
Main Authors: Hamid, Eman, Ayele, Biniyam A., Massi, Daniel Gams, Ben Sassi, Samia, Tibar, Houyam, Djonga, Emmanuel Epenge, El‐Sadig, Sarah Misbah, AMER EL KHEDOUD, Wahiba, Razafimahefa, Julien, Kouame‐Assouan, Ange Eric, Ben‐Adji, Djibrilla, Lengané, Yilédoma Thierry Modeste, Musubire, Abdu Kisekka, Mohamed, Muhyadin Hassan, Phiri, Tiwonge Elisa, Nestor, Nsengiyumva, Alwahchi, Wael Abdulgader, Neshuku, Saara Ndinelago, Ocampo, Cassandra, Sakadi, Foksouna, Maidal, Moulid Ali, Ngwende, Gift Wilson, Hooker, Juzor, Okeng'o, Kigocha, Charway‐Felli, Augustina, Atadzhanov, Masharip, Carr, Jonathan, Okubadejo, Njideka U., Shalash, Ali
Format: Article
Language:English
Subjects:
affordability
Africa
Anticholinergics
Antidepressants
availability
Bromocriptine
Clozapine
Dopamine Agonists
Ergot
Humans
Insurance coverage
Levodopa
Movement disorders
Neurodegenerative diseases
Parkinson Disease - drug therapy
Parkinson Disease - epidemiology
Parkinson's disease
Quetiapine
Serotonin uptake inhibitors
Surveys and Questionnaires
therapies
Tricyclic antidepressants
Trihexyphenidyl
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Summary: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
ISSN:0885-3185
1531-8257
DOI:10.1002/mds.28669