COVID‐19 and the state of African neurology

Ayele, Biniyam A.; Amogne, Wondwosson; Zenebe, Yared; Demissie, Hanna; Massi, Daniel Gams; El-Sadig, Sarah Misbah; Charway‐Felli, Augustina; Abd‐Allah, Foad

doi:10.1111/ene.14404

Cited by 5 publications

(8 citation statements)

References 0 publications

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“…21 A 2004 study by the World Health Organization found that while Europe has 4.84 neurologists/100,000 citizens, Africa has 0.03 neurologists/100,000 citizens. 22 The paucity of neurologists in Africa has not improved since then; Ayele et al recently commented that, “It would be a tragedy that COVID-19 was necessary to appreciate the dire shortage of neurological services in African countries, but often only such emergencies can provoke change.” 23…”

Section: Medical Barriers To the Creation And Implementation Of A National Bd/dnc Protocol In Africamentioning

confidence: 99%

“…29 Accordingly, local healers may be consulted in lieu of physicians. 23 Additionally, rather than occurring at a discrete moment, death is often viewed as a rite of passage. 30 Although views on “good” and “bad” deaths are not fixed, many in traditional African communities feel that a “good” death can only occur after a person has had time to put their affairs in order, so the suddenness of BD/DNC would inherently be viewed as “bad.” 29…”

Section: Social and Religious Considerations In The Determination Of Bd/dnc In Africamentioning

confidence: 99%

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Barriers to the Use of Neurologic Criteria to Declare Death in Africa

Lewis

Kumpfbeck

Liebman

et al. 2021

Am J Hosp Palliat Care

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There are varying medical, legal, social, religious and philosophical perspectives about the distinction between life and death. Death can be declared using cardiopulmonary or neurologic criteria throughout much of the world. After solicitation of brain death/death by neurologic criteria (BD/DNC) protocols from contacts around the world, we found that the percentage of countries with BD/DNC protocols is much lower in Africa than other developing regions. We performed an informal review of the literature to identify barriers to declaration of BD/DNC in Africa. We found that there are numerous medical, legal, social and religious barriers to the creation of BD/DNC protocols in Africa including 1) limited number of healthcare facilities, critical care resources and clinicians with relevant expertise; 2) absence of a political and legal framework codifying death; and 3) cultural and religious perspectives that present ideological conflict with the idea of BD/DNC, in particular, and between traditional and Western medicine, in general. Because there are a number of unique barriers to the creation of BD/DNC protocols in Africa, it remains to be seen how the World Brain Death Project, which is intended to create minimum standards for BD/DNC around the world, will impact BD/DNC determination in Africa.

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Section: Medical Barriers To the Creation And Implementation Of A National Bd/dnc Protocol In Africamentioning

confidence: 99%

Section: Social and Religious Considerations In The Determination Of Bd/dnc In Africamentioning

confidence: 99%

Barriers to the Use of Neurologic Criteria to Declare Death in Africa

Lewis

Kumpfbeck

Liebman

et al. 2021

Am J Hosp Palliat Care

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“…The COVID-19 pandemic, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), represents a tremendous challenge for healthcare systems, healthcare workers and the general population all over the globe. Although Africa is considered by many as relatively spared by the pandemic, the latter has caused important damages to the continent characterized by low financial resources and fragile health systems [ 1 ]. Cameroon was among the first African countries to report cases of COVID-19 [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…To date, Cameroon has officially reported 38988 positive cases with 588 deaths [ 4 ]. As in many other countries, these figures are underestimated due to the suboptimal availability of mass testing [ 1 ]. Although the manifestations of COVID-19 are predominantly respiratory, neurological complications have also been reported, involving both the peripheral and the central nervous systems with early alteration of olfaction and taste due to the tropism of the SARS-CoV-2 for the olfactory mucosa [ 5 - 11 ].…”

Section: Introductionmentioning

confidence: 99%

Neurological manifestations in patients with symptomatic COVID-19 admitted to the Bafoussam Regional Hospital, Cameroon

Fogang¹,

Noubom²,

Bassong³

et al. 2021

Pan Afr Med J

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Introduction although the main manifestations of COVID-19 are respiratory, several neurological symptoms and complications have also been reported. The pandemic seems to have some epidemiological specificities in sub-Saharan Africa, and this may be reflected in the type and frequency of neurological symptoms. This study aimed to report neurological manifestations associated with symptomatic COVID-19 in a sub-Saharan African setting. Methods we conducted a retrospective review of symptomatic PCR-confirmed COVID-19 cases admitted to the Bafoussam Regional Hospital between March and September 2020. Patients’ files were reviewed at discharge by a consultant neurologist. Socio-demographic characteristics, co-morbidities, symptoms on admission, neurological symptoms during hospitalization, management, and in-hospital outcome were recorded. Comparisons between patients with and without neurological symptoms were performed using Fisher’s exact and Mann-Whitney U test. Results we enrolled 177 symptomatic patients (68% men). Mean age was 54.6 ± 17.8 years (range 2-99 years). Co-morbidities were present in 57.6% of patients, including hypertension (27.1%) and diabetes mellitus (25.4%). Neurological symptoms were found in 113 (63.8%) patients. The most frequent were headache (39.0%), myalgia (35.6%), anosmia (11.9%), impaired consciousness (10.7%) and delirium (5.6%). Regarding the presenting symptoms, fever was more frequent in patients with neurological symptoms than in those without (81.4% versus 50.0%, p< 0.001), while digestive symptoms were less frequent in patients with neurological symptoms (0.9% versus 9.4%, p= 0.004). Conclusion neurological manifestations are frequent and heterogeneous in patients with symptomatic COVID-19. Further studies are needed to clarify the pathophysiology of neurological symptoms in COVID-19 and their impact on patients’ long-term outcome.

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“…Almost all of these patients are from Addis Ababa and surrounding cities, making them much more vulnerable to the fast-spreading virus. Neurological care in Ethiopia is significantly inadequate⸻a few trained neurologists, lack of movement disorder specialists, inadequate neurological investigations such as NCS, EMG, MRI, and unavailability of basic antiparkinsonian medications [ 2 ].…”

mentioning

confidence: 99%