Tele-neurology in sub-Saharan Africa: A systematic review of the literature

Abstract

Background The rapid advancement in telecommunications on the African continent has opened up avenues for improving medical care to underserved populations. Although the greatest burden of neurological disorders is borne by Low-and-Middle Income Countries (LMICs) including sub-Saharan Africa (SSA), there is a profound paucity of neurologists to serve the population. Telemedicine presents a promising avenue for effective mobilization and utilization of the few neurologists in Africa. Objective To systematically review the published literature on the use of telemedicine for improved care and outcomes for patients with neurological disorders in SSA. Methods We searched PubMed and Cochrane library from January 1, 1980 to April 30, 2017 using the following keywords: “Telemedicine neurology Africa”, “Teleneurology Africa”, “Telestroke Africa”, “Telerehabilitation Africa”, “Telemedicine for epilepsy”, Telemedicine for Parkinson’s disease Africa”, “Telemedicine for dementia Africa”, “Telehealth neurology Africa”. Our inclusion criteria were randomized controlled trials, or case series that reported the utilization of telemedicine for care/education of individuals with neurological disorders in Sub-Saharan Africa. Results This search yielded 6 abstracts. By consensus between two investigators, 1 publication met the criteria for inclusion and further review. The one study identified utilized telemedicine for the purpose of improving education/knowledge of 16 doctors and 17 allied health professionals in Parkinson’s disease (PD) in Cameroon. The study noted feasibility and satisfaction of participants with telemedicine as well as improved knowledge base of participants after the educational course but noted access to healthcare by patients did not change. No studies have evaluated the use of telemedicine for care of patients with neurological disorders. Conclusion The indication is that teleneurology may be feasible in SSA and studies are needed to assess feasibility, acceptability, efficacy, cost-effectiveness of this promising discipline of neurology in these resource-limited settings. We propose the setting up of trans-continental, inter-regional, intra-regional, and national networks of neurologists to utilize teleneurology platforms to improve the reach of neurology care in SSA.

Potential role of tele-rehabilitation to address barriers to implementation of physical therapy among West African stroke survivors: A cross-sectional survey

“…In fact, we have recently proposed tele-neurology and its sub-discipline such as tele-rehabilitation and mobile technology interventions for vascular risk factor control as promising avenues to improving the reach of neurology services in sub-Saharan Africa. 44–46 Our findings in the present study have identified reasons for non-attendance of physiotherapy required for recovery from stroke and has collected data of relevance in preparation for tele-rehabilitation clinical trials among stroke survivors in resource-limited settings.…”

COVID-19 and stroke: Experience in a Ghanaian healthcare system

“…The SARS-CoV-2 pandemic has wrecked untold havoc in the care of prevalent health conditions such as cancer, myocardial infarction and acute stroke in HICs [ [15] , [16] , [17] ]. A potential approach may be to accelerate the adoption of teleneurology [ [18] , [19] , [20] ] and mobile health interventions [ 21 , 22 ] for CVD risk reduction in our low-and-middle income settings in the wake of an anticipated rise in the COVID-19 cases with its associated health service delivery disruptions.…”

Parkinson's Disease Research on the African Continent: Obstacles and Opportunities

“…The training of other team members such physiotherapists, occupational and speech therapists, and dieticians, should be promoted through local neurological and international societies such as the International Parkinson and Movement Disorder Society. A previous review suggested that tele-neurology can be deployed for training of health care workers through local, regional, and intercontinental networks (61).…”