“Hey! What’s Up Doc?”
Africa and Parkinsons
You thought it will be all about Bugs Bunny since this is his famous line in Looney Tunes. You just have to read between, behind and beyond the lines. There’s something more about it.
Do you know what Michael J Fox, Muhammad Ali and Ex-Ghana captain Emmanuel Quarshie (a former Zamalek national star football player) shared in common?
Parkinsons Disease has gained more attention over the years as the media and celebrities have courageously openly addressed this disease and highlighted its affects. But what do the general public know about Parkinson’s and how do people in both developed and especially developing countries manage their daily lives once diagnosed?
Parkinson’s disease (PD) was first discovered as “shaking palsy” by James Parkinson in 1817. Its main symptoms are tremors on the extremities, rigidity (stiffness) and bradykinesia (slow movement) which greatly affects the daily activities of people with Parkinsons’ (PWPs).
Whilst often association with older people, this disease occurs worldwide, across gender and ages groups. As yet there is no cure. Many treatments and medications are however helping considerably but further study and research is needed.
And what of Parkinsons’ In Africa?
Indications show only low prevalence of PD across the Continent but to a great this is due to limited data on the disease and only rough estimates concerning PD. By way of example, a study of PD in Africa was conducted in Libya. The crude incidence rate of PD was 4.5/100 000 per year. There were no sex or age-specific data provided.
In addition to lack of research and data, across Africa many individuals also remain undiagnosed and untreated for Parkinson’s Disease due to both socio-economic and healthcare conditions.
As stated by Dr. Jacques Doumbé, a neurologist from Douala Laquintinie Hospital, Cameroon, the median number of neurologists per 100,000 population is 0.6 in the low-income countries. In Cameroon, there is 1 neurologist per 1 million population. The median number of neurological nurses per 100,000 population across different income groups of countries also varies. It is 5.04 for developed countries and 0.38 for developing countries.
Levodopa is the main medication for PD. However, there’s scarce supply and accessibility in most African countries. The estimated local cost of treatment for a PWP is approximately US$400/year (E300 annual). Across Africa much of the population may earn between US$ 2-4 a day, covering living such as food, clothing and housing. An average annual income of USD 1,500 is not enough to cover basic Parkinson’s medication at USD400 a year whilst assistance and access to knowledge on the disease remains largely out of reach.
Only 12.5% are able to access general medication compared to 79.1% in Europe. Private health insurance also is costly and in many countires across the Continent it is largely unobtainable. The high cost of Levodopa and the inability to access general health care means that the life expectancy for many Parkinsons patients can be severely limited.
Parkinson’s disease is a treatable disease but remains untreated in Africa because of limited access to PD nurse specialist, neurologist, undertreatment and underdiagnosis.
Africa is well-known for its rich culture and soccer (football) but awareness and assistance to healthcare and especially for PWPs in needed in the fight against Parkinson’s disease across the Continent.
Okubadejo NU, Bower JH, Rocca WA, Maraganore DM.Parkinson’s disease in Africa: A systematic review of epidemiologic and genetic studies. Mov Disord. 2006 Dec;21(12):2150-6.Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17044056
McInerney-Leo A, Gwinn-Hardy K, Nussbaum RL, Prevalence of Parkinson’s disease in populations of African ancestry: a review, J Natl Med Assoc. 2004 Jul;96(7):974-9.
Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15253330
Dotchin CL, Msuya O, Walker RW,The challenge of Parkinson’s disease management in Africa. Age Ageing. 2007 Mar;36(2):122-7. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17261529
Cilia R., et al, Parkinsons’s disease in sub-Saharan Africa:step-by-step i\nto the challenge, Neurodegen.Dis. Manage. 2011
EPDA Plus, Worlds Apart, Parkinson’s in South Africa
Parkinson on the move foundation