Multiple Sclerosis Research Across the African Continent: A Systematic Review (P5-3.002)

Abstract

<h3>Objective:</h3> To summarize the contemporary state of MS research across the African continent and to identify knowledge gaps from the current research landscape. <h3>Background:</h3> MS remains considered a rare neurological disorder among African populations, despite the fact that original MS research based in African countries is extremely limited or non-existent. <h3>Design/Methods:</h3> Boolean searches on the PubMed, SCOPUS and Embase databases were conducted for articles published from 1990 to February 2022. Two reviewers evaluated the title and abstract of each identified record for inclusion based on pre-defined eligibility criteria. Discrepancies between reviewers were resolved by discussion until consensus was reached. Full-text review and data extraction were conducted by a single reviewer for all articles which passed the initial title and abstract screening process. <h3>Results:</h3> After removal of duplicates, 2491 records were initially identified and underwent screening. 332 records were then selected for full-text review and 251 were deemed eligible for inclusion. The majority of included studies were from the Northern African region (<i>n</i>=204; 81%), particularly from Egypt (<i>n</i>=166; 66%), and had a case-control study design (<i>n</i>=145; 58%). Studies based in Egypt, Tunisia and South Africa accounted for ≥90% of included studies. Over 50% (<i>n</i>=150) of selected studies were published from 2016–2022, highlighting the substantial increase in research output in recent years. Studies investigating the utility of diagnostic tools (i.e. blood/serum biomarkers and neuroimaging technology) were most common (<i>n</i>=105; 42%), followed by studies investigating MS risk factors (<i>n</i>=41; 16%). <h3>Conclusions:</h3> The majority of MS research from the African continent comes from only a few countries with virtually no data from the majority of African countries. Notable gaps and barriers in our knowledge of the burden of MS in Africa remain, and further efforts to promote clinical and epidemiological MS research in sub-Saharan Africa are needed to improve our understanding of the burden of MS amongst African patients. <b>Disclosure:</b> Mr. Hwang has nothing to disclose. The institution of Dr. George has received research support from Biogen. Dr. Garcia-Dominguez has nothing to disclose. Dr. Salasky has nothing to disclose. The institution of Dr. Vishnevetsky has received research support from National MS Society. The institution of Dr. Vishnevetsky has received research support from NIH (NeuroNext). Dr. Miskin has nothing to disclose. Andy Tran has nothing to disclose. Dr. Chiluba has nothing to disclose. The institution of Dr. Saylor has received research support from National Institutes of Health. The institution of Dr. Saylor has received research support from National Multiple Sclerosis Society. The institution of Dr. Saylor has received research support from American Academy of Neurology. The institution of Dr. Saylor has received research support from United States Department of State. Dr. Saylor has a non-compensated relationship as a Member of multiple committees and task forces focused on improving access to MS medications to people across the world with Multiple Sclerosis International Federation that is relevant to AAN interests or activities. Dr. Saylor has a non-compensated relationship as a Member of the Neurology and COVID19 committee with World Health Organization that is relevant to AAN interests or activities. Dr. Saylor has a non-compensated relationship as a Member of the International Outreach Committee, Junior and Early Career Membership Committee, and Educational Innovation Commitees with American Neurological Association that is relevant to AAN interests or activities.