Evidence map›Paper›PMID 41695114›Full record

ArticleMultiple sclerosis journal - experimental, translational and clinical

Diagnostic pathways and barriers in multiple sclerosis in Zambia: A qualitative study.

Mashina Chomba, Dominique Mortel, Sarah Braun, Malya Sahu, Deanna Saylor

Abstract read
In one paragraph

Article in Multiple sclerosis journal - experimental, translational and clinical. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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.

Mashina ChombaInternal Medicine, University of Zambia School of Medicine, Lusaka, ZM, Zambia.ORCID https://orcid.org/0000-0001-9491-6025
Dominique MortelInternal Medicine, University of Zambia University Teaching Hospital, Lusaka, ZM, Zambia.ORCID https://orcid.org/0009-0003-5642-9279
Sarah BraunInternal Medicine, University of Zambia University Teaching Hospital, Lusaka, ZM, Zambia.ORCID https://orcid.org/0009-0007-8493-3121
Malya SahuDepartment of Neurology, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.ORCID https://orcid.org/0009-0004-1875-5679
Deanna SaylorDepartment of Neurology, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.

Funding

UJMT – ORWH – Gazzetta, Issa-BoubeD43TW009340 · FIC · UNIV OF NORTH CAROLINA CHAPEL HILL · PI William Checkley, Benjamin H. Chi · 2017 to 2026
$14.8M
Adaptation and Implementation of Clinical Practice Guidelines to Improve Stroke Outcomes in ZambiaK01TW011771 · FIC · UNIV OF NORTH CAROLINA CHAPEL HILL · PI SAYLOR, DEANNA RAE · 2021 to 2025
$1.1M
FIC NIH HHS D43 TW009340FIC NIH HHS K01 TW011771
6 · The paper itself

Abstract

Background: Multiple sclerosis remains under-recognized in Zambia and much of sub-Saharan Africa, often leading to misdiagnosis and delays. Understanding diagnostic pathways and barriers can inform strategies to improve multiple sclerosis recognition and care. Objectives: This study explores the diagnostic journeys of adults with multiple sclerosis in Zambia, emphasizing the challenges encountered at each stage. Methods: We conducted a qualitative study using semi-structured interviews with adults diagnosed with multiple sclerosis in Zambia. Thematic analysis identified patterns in diagnostic experiences, enabling the mapping of common pathways and barriers, along with patient perspectives on the impact of diagnostic delays. Results: Thirteen individuals with relapsing-remitting multiple sclerosis (mean age 34 ± 11 years; 70% female) were enrolled. Diagnostic pathways involved multiple healthcare visits, frequent misdiagnoses, and substantial delays. Key barriers included limited magnetic resonance imaging access, low multiple sclerosis awareness, and financial constraints. Thematic findings highlighted misinterpretation of symptoms, lack of specialists, and systemic health system limitations. Delayed diagnosis had a significantly negative impact on patients' lives. Conclusion: Multiple sclerosis diagnosis in Zambia is markedly delayed, adversely affecting patients. Greater awareness and policy reforms targeting diagnostic barriers are needed to promote earlier diagnosis and improve outcomes in Zambia and similar resource-limited settings.

Indexed as

AfricaEpidemiologymultiple sclerosis

Identifiers

PMID41695114
PMCPMC12901886

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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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.