Division of Neurology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Division of Neurology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Eur J Neurol. 2021 Jan;28(1):81-89. doi: 10.1111/ene.14499. Epub 2020 Sep 24.
Little is known about the epidemiological features of amyotrophic lateral sclerosis (ALS) in sub-Saharan Africa, and data from the region are limited to clinical series or case reports. The aim of the study was to investigate the incidence rate and presentation of ALS in an ethnically diverse region of South Africa.
We performed a 4-year prospective incidence study in the Western Cape Province of South Africa between 1 July 2014 and 30 June 2018, and used a two-source capture-recapture method for case ascertainment. Age- and sex-adjusted incidence rates (ASAIRs) were calculated using the 2010 US population as the reference.
A total of 203 incident cases were identified over the study period, resulting in a crude incidence rate (IR) of 1.09 [95% confidence interval (CI) 0.94-1.24] per 100 000 person-years in the at-risk population (aged >15 years). Capture-recapture analysis resulted in an estimated IR of 1.11 (95% CI 1.01-1.22) per 100 000 person-years. The ASAIR was 1.67 (95% CI 1.09-2.26) overall; 1.99 (95% CI 1.60-2.39) for men and 1.37 (95% CI 1.06-1.68) for women. When analysed separately, there was a substantial difference in ASAIRs between the different population groups, with the highest in the European ancestry group (2.62; 95% CI 2.49-2.75), the lowest in the African ancestry group (0.56, 95% CI 0.0-1.23), and an ASAIR in between these two in the mixed ancestry group (1.09, 95% CI 0.80-1.37).
The overall incidence of ALS in the Western Cape Province of South Africa appears to be lower than in North African and Western countries, but higher than in Asian countries. As suggested by previous epidemiological studies, ALS may be less frequent in people of African ancestry.
人们对撒哈拉以南非洲地区肌萎缩侧索硬化症（ALS）的流行病学特征知之甚少，且该地区的数据仅限于临床系列或病例报告。本研究的目的是调查南非一个种族多样化地区的 ALS 发病率和表现。
我们在 2014 年 7 月 1 日至 2018 年 6 月 30 日期间在南非西开普省进行了一项为期 4 年的前瞻性发病率研究，并使用双源捕获-再捕获法进行病例确定。使用 2010 年美国人口作为参考，计算年龄和性别调整发病率（ASIR）。
研究期间共发现 203 例新发病例，导致高危人群（年龄>15 岁）的粗发病率（IR）为 1.09 [95%置信区间（CI）0.94-1.24] / 100000 人年。捕获-再捕获分析得出的估计 IR 为 1.11（95%CI 1.01-1.22）/ 100000 人年。ASIR 为 1.67（95%CI 1.09-2.26）；男性为 1.99（95%CI 1.60-2.39），女性为 1.37（95%CI 1.06-1.68）。单独分析时，不同人群的 ASAIR 存在显著差异，其中欧洲血统组最高（2.62；95%CI 2.49-2.75），非洲血统组最低（0.56，95%CI 0.0-1.23），混合血统组介于两者之间（1.09，95%CI 0.80-1.37）。
南非西开普省的 ALS 总发病率似乎低于北非和西方国家，但高于亚洲国家。正如先前的流行病学研究表明的那样，非洲血统的人可能患 ALS 的频率较低。
