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Abstract Details

More Than Meets the Eye: A Closer Look At Demyelinating Diseases In Zambia
Global Health and Neuroepidemiology
P4 - Poster Session 4 (8:00 AM-9:00 AM)
10-015
Describe demographic and clinical characteristics of Zambian adults with MS and neuromyelitis optica (NMO).

MS and other demyelinating diseases are reportedly rare in sub-Saharan Africa and remain understudied.

Adults diagnosed with either MS, NMO, NMO spectrum disorder (NMOSD), or clinically isolated syndrome (CIS) at the only neurology outpatient clinic in Zambia were eligible to participate from October 2019 to February 2022. An MS-trained nurse administered structured questionnaires regarding sociodemographic characteristics, and each participant also underwent a comprehensive neurological history and examination by a neurologist. Finally, plasma 25-hydroxyvitamin D levels were obtained. For analysis, the cohort was dichotimized into a MS/CIS disease group and NMO/NMOSD disease group. Descriptive statistics of the cohort are presented and compared between both groups.
Amongst the 34 participants, mean age was 36 + 9 years, 65% (n=22) were female, 90% were Black-African, 10% were of Southeast Asian decent, 50% had MS/CIS, and 50% had NMO/NMOSD. The average age was 34 + 11 years in the MS/CIS group and 37 + 7 years in the NMO/NMOSD group (p=0.28). Females constituted 65% (n=11) of both disease groups. Median time to diagnosis was 242 days (interquartile range IQR: 91-974) and did not differ significantly between the groups. The majority (82%) of the NMO/NMOSD group presented with bilateral optic neuritis. Among the MS/CIS group, median EDSS was 4 (IQR: 2.25-4.25), median Disease Steps were 2 (IQR: 1-2), and 59% (n=10) had an abnormal gait at enrollment. Median 25-hydroxyvitamin D level was 29 (IQR: 24-46) ng/mL in the overall cohort but did not differ by disease group or supplementation status.

In this sub-Saharan African cohort of adults with demyelinating diseases, MS and NMO were equally prevalent. Delays in diagnosis resulted in high levels of disability in both groups.
Authors/Disclosures
Dominique Mortel, MD (Phoebe Neurology)
PRESENTER 		Dr. Mortel has nothing to disclose.
Sarah Braun, MD (University Teaching Hospital, Lusaka, Zambia) Sarah Braun has nothing to disclose.
Lorraine Chishimba, MBChB, MMED (University Teaching Hospital) Dr. Chishimba has nothing to disclose.
Mashina Chomba, MBChB (University of Zambia) Dr. Chomba has nothing to disclose.
Frighton B. Mutete, MBChB (Livingstone University Teaching Hospital) Dr. Mutete has nothing to disclose.
Naluca Mwendaweli, MMED (University Teaching Hospital) NALUCA MWENDAWELI has nothing to disclose.
Coolwe Namangala Dr. Namangala has nothing to disclose.
Stanley Zimba, MBBS (University Teaching Hospital) Dr. Zimba has nothing to disclose.
Deanna Saylor, MD, MHS (Johns Hopkins Hospital) Dr. Saylor has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for 好色先生. The institution of Dr. Saylor has received research support from National Institutes of Health. The institution of Dr. Saylor has received research support from 好色先生. 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 好色先生al Innovation Commitees with American Neurological Association that is relevant to AAN interests or activities.