Clinical features and prognosis of amyotrophic lateral sclerosis in Africa: the TROPALS study. Issue 1 (21st September 2018)

• Record Type: Journal Article
• Authors: Luna, Jaime; Diagana, Mouhamadou; Ait Aissa, Leila; Tazir, Meriem; Ali Pacha, Lamia; Kacem, Imen; Gouider, Riadh; Henning, Franclo; Basse, Anna; Cisse, Ousmane; Balogou, Agnon Ayélola Koffi; Kombate, Damelan; Agbetou, Mendinatou; Houinato, Dismand; Millogo, Athanase; Agba, Thierry; Belo, Mouftao; Penoty, Marie; Raymondeau-Moustafa, Marie; Hamidou, Bello; Couratier, Philippe; Preux, Pierre Marie; Marin, Benoit
• Other Names: author non-byline.; Aissa Leila Ait author non-byline.; Pacha Lamia Ali author non-byline.; Tazir Meriem author non-byline.; Nadia Toubal author non-byline.; Adjien Constant author non-byline.; Agbetou Atokè Mendinatou author non-byline.; Avode Gilbert author non-byline.; Houinato Dismand author non-byline.; Millogo Athanase author non-byline.; Couratier Philippe author non-byline.; Hamidou Bello author non-byline.; Luna Jaime author non-byline.; Marin Benoît author non-byline.; Penoty Marie author non-byline.; Preux Pierre Marie author non-byline.; Raymondeau-Moustafa Marie author non-byline.; Assegone Zeh Yvonne author non-byline.; Ndouongo Philomène Kouna author non-byline.; Mouangue Gertrude author non-byline.; Ngoungou Edgard author non-byline.; Cisse Fode Abass author non-byline.; Cisse Amara author non-byline.; Diallo Lansana Laho author non-byline.; Diakite Sara author non-byline.; Maiga Youssoufa author non-byline.; Diagana Mouhamadou author non-byline.; Hace Cheikh Ould author non-byline.; Moulaye Abderrahmane author non-byline.; Basse Anna author non-byline.; Cisse Ousmane author non-byline.; Diop Amadou Gallo author non-byline.; Mansour Ndiaye author non-byline.; Henning Franclo author non-byline.; Damelan Kombate author non-byline.; Koffi Balogou Agnon A author non-byline.; Agba Thierry author non-byline.; Belo Mouftao author non-byline.; Nyinévi Anayo author non-byline.; Gargouri Amina author non-byline.; Gouider Riadh author non-byline.; Kacem Imen author non-byline.;
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 90:Issue 1(2019)
• Page Start: 20
• Page End: 29
• Publication Date: 2018-09-21
• Subjects: amyotrophic lateral sclerosis -- clinical features -- prognosis -- riluzole -- Africa; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2018-318469
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Objective: We describe and compare the sociodemographic and clinical features, treatments, and prognoses and survival times of patients with amyotrophic lateral sclerosis (ALS) in Africa. Methodology: We 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. Results: Nine 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, p<0.0001). Both subcontinental location and riluzole treatment independently affected survival. Conclusion: More 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.