1. Clinical features and prognosis of amyotrophic lateral sclerosis in Africa: the TROPALS study
- Author
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Leila Ait Aissa, Mendinatou Agbétou, Ousmane Cisse, Dismand Houinato, Pierre-Marie Preux, Meriem Tazir, Jaime Luna, Marie Penoty, Philippe Couratier, Athanase Millogo, Imen Kacem, Marie Raymondeau-Moustafa, Agnon Ayelola Koffi Balogou, Riadh Gouider, M Belo, Bello Hamidou, Benoît Marin, Damelan Kombate, Mouhamadou Diagana, Anna Modji Basse, Franclo Henning, Lamia Ali Pacha, Thierry Agba, Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Neurologie, Hopital Mustapha, CHU Mustapha, Le centre hospitalier universitaire (CHU) Mustapha Pacha [Alger], Hopital de Razi - Razi Hospital [Tunis], Stellenbosch University, Service de Neurologie, CHU Campus Université de Lomé, Service de Neurologie, CHU Campus Université de Lomé-Service de Neurologie, CHU Campus Université de Lomé, Université de Parakou (UP), University of Abomey Calavi (UAC), Centre Hospitalier Universitaire Souro Sanou [Bobo-Dioulasso] (CHUSS), Université de Lomé [Togo], Service de Neurologie [CHU Limoges], CHU Limoges, Unité Fonctionnelle de Recherche Clinique et de Biostatistique (UFRCB), Service de l'Information Médicale et de l'Évaluation [CHU Limoges] (SIME), Laboratoire de Biostatistique et d'Informatique Médicale, Université de Limoges (UNILIM), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), and Université de Limoges (UNILIM)-Université de Limoges (UNILIM)
- Subjects
Adult ,medicine.medical_specialty ,amyotrophic lateral sclerosis ,Neurology ,clinical features ,Subgroup analysis ,Disease ,Africa, Southern ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Africa, Northern ,Internal medicine ,Humans ,Medicine ,Age of Onset ,Sex Distribution ,Amyotrophic lateral sclerosis ,Aged ,Proportional Hazards Models ,business.industry ,Proportional hazards model ,Middle Aged ,medicine.disease ,riluzole ,3. Good health ,Riluzole ,Survival Rate ,Africa, Western ,Psychiatry and Mental health ,Neuroprotective Agents ,Africa ,Surgery ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Neurology (clinical) ,prognosis ,business ,030217 neurology & neurosurgery ,Median survival ,Cohort study ,medicine.drug - Abstract
ObjectiveWe describe and compare the sociodemographic and clinical features, treatments, and prognoses and survival times of patients with amyotrophic lateral sclerosis (ALS) in Africa.MethodologyWe conducted a multicentre, hospital-based cohort study in Africa. Patients with ALS diagnosed in the neurology departments of participating hospitals from 2005 to 2017 were included. Subgroup analysis was performed by subcontinent. Survival analyses were conducted using the Cox proportional hazards model.ResultsNine centres from eight African countries participated. A total of 185 patients with ALS were included: 114 from Northern Africa, 41 from Western Africa and 30 from Southern Africa. A male predominance (male to female ratio 2.9) was evident. The median age at onset was 53.0 years (IQR 44.5–64.0 years). The onset was bulbar in 22.7%. Only 47 patients (26.3%) received riluzole, mainly in Northern and Western Africa. The median survival from the time of diagnosis was 14.0 months (95% CI 10.7 to 17.2 months). The median survival was longer in Northern Africa (19.0 months, 95% CI 10.8 to 27.2 months) than in Western (4.0 months, 95% CI 0.8 to 7.1 months) and Southern (11.0 months, 95% CI 5.6 to 16.4 months) Africa (Breslow test, pConclusionMore African patients with ALS were male and younger and exhibited a lower proportion of bulbar onset compared with patients with ALS from Western nations. Survival was consistent with that in Western registers but far shorter than what would be expected for young patients with ALS. The research improves our understanding of the disease in Africa.
- Published
- 2019
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