The management of Parkinson's disease in sub-Saharan Africa.

The vast majority of patients with Parkinson's disease (PD) in sub-Saharan Africa are undiagnosed and untreated with impaired quality of life and markedly increased mortality rates. PD is a progressive neurodegenerative disorder that becomes increasingly common as people age. Diagnosis remains predominantly clinical based on motor symptoms: tremor, rigidity, bradykinesia and postural instability. In developed countries, it is well recognized and very few patients will not be diagnosed and treated. However, in developing countries, such as those in sub-Saharan Africa, evidence suggests that most patients are undiagnosed, and even if they are diagnosed, they do not have access to sustainable, affordable, drug treatment and medical supervision. There is a lack of awareness, both within the general population and also among healthcare professionals, and many patients seek help from traditional healers. Even if they are diagnosed, treatment is often too expensive, and supplies are sporadic. There is a great need to increase awareness of PD within the general population and the fact that the symptoms are treatable. Education of healthcare workers about PD is also important, but a major challenge is there are few doctors and even fewer neurologists. Awareness raising and training will be to no avail, unless the problem of an affordable, reliable supply of drug treatment can be tackled.