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Melka D, Demisse H, Assefa H, Zenebe Y, A Ayele B, Awraris M, Gelan Y, Kifelew S, Fedlu M, Tsehayneh F, Zebenigus M, Alemayehu S, Tesfaye H, Gulelat H, Guta T, Tafesse A, Bekele N, Saez M, Veldink JH, Al-Chalabi A, Povedano M, Al Khleifat A. Epidemiological and clinical profile of amyotrophic lateral sclerosis in Ethiopia: a 5-year multicenter retrospective study. Amyotroph Lateral Scler Frontotemporal Degener 2023:1-9. [PMID: 37496277 DOI: 10.1080/21678421.2023.2238016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/28/2023] [Accepted: 06/30/2023] [Indexed: 07/28/2023]
Abstract
Background: Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that results in progressive weakness of skeletal muscles including respiratory muscles. Epidemiological and clinical aspects of ALS are derived from a few world regions with very little representation of low- and middle-income countries. We therefore set out to determine the epidemiological and clinical phenotype of individuals with ALS in Ethiopia. Methods: Multicenter retrospective analysis was conducted using clinical records from ALS patients seen in Ethiopia at Tikur Anbessa Specialized Hospital and Yehuleshet specialty clinic between January 2016 and August 2021. The data collected included clinical characteristics, disease-related symptoms, a revised ALS functional rating scale, and medications. Results: Patients in Ethiopia had a younger age of onset with a mean age of disease onset of 51.9 years. 2.9% of patients had juvenile ALS, and the male-to-female ratio was almost 2:1. 4.9% had a positive family history of the disease. 68% of patients had spinal region involvement at onset, while 32% had bulbar region involvement at onset. Riluzole was used by 31% of ALS patients. 20.6% of patients had some respiratory symptoms, but none received a standard respiratory function assessment. 33.3% of patients were wheelchair-bound. Conclusion: In this retrospective study spanning 5 years, we examined the clinical phenotype of ALS in Ethiopian patients. Our findings suggest that most patients had clinically definite ALS with spinal region involvement. Further research, including genetic and epigenetic information, is necessary to understand the early onset of the disease in Ethiopia.
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Affiliation(s)
- Dereje Melka
- Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Hanna Demisse
- Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Hanna Assefa
- Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yared Zenebe
- Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Biniyam A Ayele
- Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Meron Awraris
- Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yohannese Gelan
- Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Selam Kifelew
- Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Medina Fedlu
- Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Fikiru Tsehayneh
- Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mehila Zebenigus
- Department of Neurology, Yehuleshet Specialty Clinic, Addis Ababa, Ethiopia
| | - Samson Alemayehu
- Department of Neurology, Yehuleshet Specialty Clinic, Addis Ababa, Ethiopia
| | | | | | - Tsega Guta
- Yehuleshet Specialty Clinic, Addis Ababa, Ethiopia
| | - Abenet Tafesse
- Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Nebiyu Bekele
- Department of Internal Medicine Neurology Unit, College of Health Science, University of Gondar, Gondar, Ethiopia
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública/Center for Biomedical Research in Epidemiology and Public Health Network (CIBERESP), Madrid, Spain
| | - Jan H Veldink
- Department of Neurology, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Ammar Al-Chalabi
- Department of Basic and Clinical, Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK, and
| | - Monica Povedano
- Department of Neurology, Bellvitge University Hospital, Barcelona, Spain
| | - Ahmad Al Khleifat
- Department of Basic and Clinical, Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK, and
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Blacker SN, Woody N, Abate Shiferaw A, Burbridge M, Bustillo MA, Hazard SW, Heller BJ, Lamperti M, Mejia-Mantilla J, Nadler JW, Rath GP, Robba C, Vincent A, Admasu AK, Awraris M, Lele AV. Differences in Perioperative Management of Patients Undergoing Complex Spine Surgery: A Global Perspective. J Neurosurg Anesthesiol 2023; Publish Ahead of Print:00008506-990000000-00063. [PMID: 37192477 DOI: 10.1097/ana.0000000000000919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/29/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND The aim of this survey was to understand institutional spine surgery practices and their concordance with published best practices/recommendations. METHODS Using a global internet-based survey examining perioperative spine surgery practice, reported institutional spine pathway elements (n=139) were compared with the level of evidence published in guideline recommendations. The concordance of clinical practice with guidelines was categorized as poor (≤20%), fair (21%-40%), moderate (41%-60%), good (61%-80%), or very good (81%-100%). RESULTS Seventy-two of 409 (17.6%) institutional contacts started the survey, of which 31 (7.6%) completed the survey. Six (19.4%) of the completed surveys were from respondents in low/middle-income countries, and 25 (80.6%) were from respondents in high-income countries. Forty-one incomplete surveys were not included in the final analysis, as most were less than 40% complete. Five of 139 (3.6%) reported elements had very good concordance for the entire cohort; hospitals with spine surgery pathways reported 18 elements with very good concordance, whereas institutions without spine surgery pathways reported only 1 element with very good concordance. Reported spine pathways included between 7 and 47 separate pathway elements. There were 87 unique elements in the reviewed pathways. Only 3 of 87 (3.4%) elements with high-quality evidence demonstrated very good practice concordance. CONCLUSIONS This global survey-based study identified practice variation and low adoption rates of high-quality evidence in the care of patients undergoing complex spine surgery.
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Affiliation(s)
- Samuel N Blacker
- Department of Anesthesiology, University of North Carolina, Chapel Hill, NC
| | - Nathan Woody
- Department of Anesthesiology, University of North Carolina, Chapel Hill, NC
| | | | - Mark Burbridge
- Department of Anesthesiology, Perioperative and Pain Management, Stanford University School of Medicine, Stanford, CA
| | - Maria A Bustillo
- Department of Anesthesiology, Weill Cornell Medical College, New York City, NY
| | - Sprague W Hazard
- Department of Anesthesiology and Critical Care Medicine, Penn State Health, PA
| | - Benjamin J Heller
- Department of Anesthesiology and Pain Medicine, The University of Texas Southwestern Medical Center, Dallas, TX
| | - Massimo Lamperti
- Anesthesiology Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - Jorge Mejia-Mantilla
- Department of Anesthesiology and Perioperative Medicine, University of Rochester Medical Center, Rochester, NY
| | - Jacob W Nadler
- Department of Neuroanaesthesiology and Critical Care, Neurosciences Centre, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | | | - Chiara Robba
- Department of Anesthesiology and Critical Care Medicine, George Washington University Hospital, Washington, DC
| | | | - Azarias K Admasu
- Department of Neurology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Meron Awraris
- Department of Anesthesiology, Fundación Valle Del Lili, Cali, Colombia
| | - Abhijit V Lele
- Department of Anesthesiology and Pain Medicine, Harborview Medical Center, University of Washington, Seattle, WA
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Nigatu D, Tigabu T, Awraris M, Yohannes A, Kebede D. Guillain-Barré Syndrome Associated with SARS CoV-2 Infection: Case Report. Ethiop J Health Sci 2022; 32:205-208. [PMID: 35250231 PMCID: PMC8864392 DOI: 10.4314/ejhs.v32i1.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 10/12/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Since the outbreak of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV2) in December 2019, there have been some case reports of Coronavirus disease 19 (COVID 19) associated Guillain-Barré Syndrome (GBS). GBS is an inflammatory polyradiculoneuropathy associated with numerous viral and bacterial infections. Here we describe the case of an Ethiopian man with a typical clinical and electrophysiological manifestation of GBS. CASE PRESENTATION A 70-year-old male presented with four days history of progressive and ascending bilateral limbs weakness which end up with respiratory failure. He had an antecedent headache, loss of appetite, and generalized fatigue. Electrophysiological studies showed Acute Motor and Sensory Axonal Neuropathy whereas and cerebrospinal fluid analysis revealed albuminocytologic dissociation with positive preintubation SARS CoV2 test. He was treated with supportive care and recovered successfully. CONCLUSION This case illustrates one of the few occasions when patients with mild COVID-19 develop severe neurologic manifestations. Seemingly, early identification and management can improve clinical outcomes. We would like to emphasize the need to consider screening for SARS CoV-2 in patients presenting with GBS.
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Affiliation(s)
- Dereje Nigatu
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tsion Tigabu
- Eka Kotebe General Hospital, Addis Ababa Ethiopia
| | - Meron Awraris
- Department of Neurology, School of Medicine, Addis Ababa University, Ethiopia
| | - Andargew Yohannes
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Dawit Kebede
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
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Ayele BA, Demissie H, Awraris M, Amogne W, Shalash A, Ali K, Zenebe Y, Tafesse A, Venkatasubba Rao CP. SARS-COV-2 induced Parkinsonism: The first case from the sub-Saharan Africa. Clin Park Relat Disord 2021; 5:100116. [PMID: 34786554 PMCID: PMC8582125 DOI: 10.1016/j.prdoa.2021.100116] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/08/2021] [Accepted: 10/30/2021] [Indexed: 12/05/2022] Open
Affiliation(s)
- Biniyam A. Ayele
- Department of Neurology, Addis Ababa University, PoBox 6396, Liberia Street, Addis Ababa, Ethiopia
| | - Hanna Demissie
- Department of Neurology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Meron Awraris
- Department of Neurology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Wondwossen Amogne
- Department of Internal Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ali Shalash
- Department of Neurology, Ain Shams University, Cairo, Egypt
| | - Kemal Ali
- Department of Neurology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yared Zenebe
- Department of Neurology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abenet Tafesse
- Department of Neurology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Chethan P. Venkatasubba Rao
- Department of Neurology and Neurosurgery, Vascular Neurology and Neurocritical Care, Baylor College of Medicine, USA
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Ayele BA, Zenebe Y, Demissie H, Tafesse A, Melka D, Debebe Y, Tsehayneh F, Awraris M, Shalash A. Impact of COVID-19 on the clinical care of Ethiopian PD patients: A glimpse into the burden. eNeurologicalSci 2020; 21:100273. [PMID: 32954019 PMCID: PMC7491477 DOI: 10.1016/j.ensci.2020.100273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/07/2020] [Accepted: 09/11/2020] [Indexed: 11/02/2022] Open
Affiliation(s)
- Biniyam A Ayele
- Department of Neurology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yared Zenebe
- Department of Neurology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Hanna Demissie
- Department of Neurology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abenet Tafesse
- Department of Neurology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Dereje Melka
- Department of Neurology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yohannes Debebe
- Department of Neurology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Fikru Tsehayneh
- Department of Neurology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Meron Awraris
- Department of Neurology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ali Shalash
- Department of Neurology, Ain Shams University, Cairo, Egypt
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