Evidence map›Paper›PMID 33553703›Full record

ArticleeNeurologicalSci2021

Cases of neuromyelitis optica spectrum disorder from the East Africa region, highlighting challenges in diagnostics and healthcare access.

Dilraj Sokhi, Adil Suleiman, Soraiya Manji, Juzar Hooker, Peter Mativo

Open access · goldAbstract read
In one paragraph

Article in eNeurologicalSci, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.1field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Neuromyelitis Optica Spectrum Disorder: A Case Report.International medical case reports journal · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Dilraj SokhiDepartment of Medicine, Faculty of Health Sciences, Aga Khan University Medical College of East Africa, Nairobi, Kenya.
Adil SuleimanDepartment of Medicine, Faculty of Health Sciences, Aga Khan University Medical College of East Africa, Nairobi, Kenya.
Soraiya ManjiDepartment of Medicine, Faculty of Health Sciences, Aga Khan University Medical College of East Africa, Nairobi, Kenya.
Juzar HookerThe Aga Khan University Hospital, Nairobi, Kenya.
Peter MativoDepartment of Medicine, Faculty of Health Sciences, Aga Khan University Medical College of East Africa, Nairobi, Kenya.
Aga Khan University Hospital Nairobi · KE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNeuromyelitis optica spectrum disorder (NMOSD) is an auto-immune disease of the central nervous system (CNS) associated with the IgG-antibody against aquaporin-4 (AQP4-IgG). There is little published epidemiology of NMOSD from sub-Saharan Africa (SSA).

methodsWe retrospectively collated NMOSD cases admitted to our tertiary regional neurology centre.

resultsWe identified 11 cases (10 female, average age 30 years). 64% (7/11) were seropositive for AQP4-IgG, measured using indirect immunofluorescence. The remaining cases could either not afford tests, or had pathognomonic radiological features. 57% (4/7) of seropositive cases had concurrent/recent CNS infection. All patients were treated with high-dose intravenous methylprednisolone (IVMP), and 36% (4/11) also had plasma exchange. Only 55% (6/11) of the patients were seen by a neurologist at presentation: they had less relapses (1.3 vs 2.4), less diagnostic delay (2.3 vs 7.4 months), and were less disabled at the end of our review period. 10 cases were immunosuppressed long-term: 60% on mycophenolate, 30% azathioprine, and one on rituximab.

conclusionOur study is the largest case series of NMOSD from the East Africa region. Patients faced challenges of access to appropriate and affordable testing, and timely availability of a neurologist at onset, which had impacts on their functional outcomes. The majority of the seropositive cases had recent/concurrent CNS infections, suggesting triggered auto-immunity.

Indexed as

CNS, Central nervous systemCSF, Cerebrospinal fluidEDSS, Extended Disability Status ScaleHIV, Human immunodeficiency virusHSV-2, Herpes simplex virus type 2ICD-10, nternational Classification of Diseases version 10IPND, International Panel for NMOSD DiagnosisIVMP, Intravenous methylprednisoloneLETM, Longitudinally extensive tranverse myelitisMMF, Mycophenolate mofetilMOG, Myelin oligodendrocyte glycoproteinMRI, Magnetic resonance imagingnd, not doneNeuro-immunologyNeuro-inflammationNeuromyelitis optica spectrum disorderNMOSD, Neuromyelitis optica spectrum disorderOCBs, Oligoclonal bandsON, Bilateral simultaneous or sequential optic neuritisPLEX, Plasma exchangeRRMS, Relapsing-remitting multiple sclerosisRTX, RituximabSub-Saharan AfricaTPHA, Treponema pallidum haemagglutination assay

Identifiers

PMID33553703
PMCPMC7844578
OpenAlexW3124443336

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.