Neuromyelitis Optica Spectrum Disorders in Africa (A Narrative Review of 622 Cases)

Abstract

Neuromyelitis Optica spectrum disorders (NMOSD) are a group of inflammatory disorders of the CNS, characterized by severe attacks of optic neuritis and myelitis. There are very few epidemiological studies of NMOSD in Africa. The purpose is to provide descriptive details of all cases published and reported in scientific meetings, analyze epidemiological, clinical, paraclinical, therapeutic, and outcome profiles of NMOSD in Africa and compare our data with literature. Authors did a literature search using MEDLINE, EMBASE, SCIENCE DIRECT, and GOOGLE SCHOOLAR. The search further extended to international and local journals, as well as regional and national meetings for all reports and articles about NMOSD in Africa. Till the end of 2019, 622 cases were reported in Africa, originating from 21 countries. The average age at disease onset was 32.5 years and the women to men ratio was 2.78:1. The big majority of patients underwent both brain MRI and serum aquarporin-4 antibody testing. The prognosis was generally unfavorable, with motor and/or visual sequelae. This 1st report of NMOSD in Africa does not reflect reality; theoretical number is around 50,000 cases, due certainly to considerable gap with many under-diagnosed and certainly misdiagnosed cases, due to many factors.