The Current State of Diagnostics for Neuroimmunological Disorders in Africa

Abstract

The epidemiology of neuroimmunological disorders in Africa remains poorly understood. Regional variation in diagnostics and provider knowledge has led to challenges in real-world application of diagnostic criteria. We conducted a cross-sectional survey of clinicians practicing in Africa to characterize the current state of clinical diagnostic resources and developed a clinician-driven prioritized action plan. 130 respondents from 24 out of 54 countries in Africa participated (44% national response rate). Most respondents specialized in neurology (n = 86, 66%) and practiced in an urban setting (n = 84, 65%). While all participating countries had access to a neurologist and ophthalmologist, only half had access to an in-country neuroimmunologist. Three-quarters of respondents had access to an MRI within a 25-kilometer radius with most reporting a maximum magnet strength of 1.5 Tesla (n = 46, 61%). The median cost for an MRI brain was 150 USD, and MRI spine was 160 USD. The most urgent action item selected to improve the timely diagnosis of neuroimmunological conditions was subsidizing the cost of MRI followed by increasing availability of MRI. There were notable gaps in availability of specialists and access to MRI to diagnose neuroimmunological conditions in Africa. Urgent action and regional collaborations focused on addressing MRI cost and availability are needed.