Motor neuron disease in black African patients at a tertiary care hospital in Soweto, South Africa.

Abstract

IntroductionIn this brief report, we describe the nature of ALS in a South African cohort of patients of Black African ancestry – a population which has been historically understudied. MethodsWe performed a chart review of all patients attending the ALS/MND clinic at the Chris Hani Baragwanath Academic Hospital in Soweto, Johannesburg, South Africa, during the period 1 January 2015 to 30 June 2020. Cross-sectional demographic and clinical data captured at the time of diagnosis was collected. ResultsSeventy-one patients were included in the study. Males constituted 66% (n = 47), with a male to female sex ratio of 2:1. The median age at onset of symptoms was 46 years (IQR 40–57) with a median disease duration at diagnosis (diagnostic delay) of 2 years (IQR 1–3). The onset was spinal in 76% and bulbar in 23%. The median ALSFRS-R score at time of presentation was 29 (IQR 23–38.5). The median ALSFRS-R slope (unit/month) was 0.80 (IQR 0.43–1.39). Sixty five patients (92%) were diagnosed with the classic ALS phenotype. Fourteen patients were known to be HIV positive, and of those, 12 were on antiretroviral treatment (ART). None of the patients had familial ALS. ConclusionOur findings of an earlier age at symptom onset and seemingly advanced disease at presentation in patients with Black African ancestry support the existing literature on the African population.