{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:14:31Z","timestamp":1790032471857,"version":"4.0.1"},"reference-count":52,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["D43TW009340"],"award-info":[{"award-number":["D43TW009340"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["K01TW011771"],"award-info":[{"award-number":["K01TW011771"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005339","name":"American Academy of Neurology","doi-asserted-by":"publisher","award":["Neurodisparities Clinical Research Training Schola"],"award-info":[{"award-number":["Neurodisparities Clinical Research Training Schola"]}],"id":[{"id":"10.13039\/100005339","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cent Nerv Syst Dis"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:p>The epidemiology of neuroimmunological disorders in Africa remains poorly understood. Regional variation in diagnostics and provider knowledge has led to challenges in real-world application of diagnostic criteria. We conducted a cross-sectional survey of clinicians practicing in Africa to characterize the current state of clinical diagnostic resources and developed a clinician-driven prioritized action plan. 130 respondents from 24 out of 54 countries in Africa participated (44% national response rate). Most respondents specialized in neurology (n = 86, 66%) and practiced in an urban setting (n = 84, 65%). While all participating countries had access to a neurologist and ophthalmologist, only half had access to an in-country neuroimmunologist. Three-quarters of respondents had access to an MRI within a 25-kilometer radius with most reporting a maximum magnet strength of 1.5\u00a0Tesla (n = 46, 61%). The median cost for an MRI brain was 150 USD, and MRI spine was 160 USD. The most urgent action item selected to improve the timely diagnosis of neuroimmunological conditions was subsidizing the cost of MRI followed by increasing availability of MRI. There were notable gaps in availability of specialists and access to MRI to diagnose neuroimmunological conditions in Africa. Urgent action and regional collaborations focused on addressing MRI cost and availability are needed.<\/jats:p>","DOI":"10.1177\/11795735251385319","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T16:03:04Z","timestamp":1763568184000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["The Current State of Diagnostics for Neuroimmunological Disorders in Africa"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1875-5679","authenticated-orcid":false,"given":"Malya","family":"Sahu","sequence":"first","affiliation":[{"name":"University of North Carolina at Chapel Hill"},{"name":"Department of Neurology, University Teaching Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mashina","family":"Chomba","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Teaching Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiifi","family":"Duodu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Korle Bu Teaching Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica M.","family":"Diaz","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilraj","family":"Sokhi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Aga Khan University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deanna","family":"Saylor","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Teaching Hospital"},{"name":"University of North Carolina at Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.18103\/mra.v12i11.6105"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458507079274"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/2055217319841881"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/nxi.0000000000001089"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000011153"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/2055217317730098"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24617"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.31579\/2690-4861\/608"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/jramc-2019-001338"},{"key":"e_1_3_7_11_2","first-page":"70","article-title":"The Maritime Silk Road: case report of Neuro-Beh\u00e7et\u2019s disease from Somalia with positive HLA-B51 haplotype","volume":"10","author":"Iyer A","year":"2022","unstructured":"Iyer A, Otieno F, Sokhi D. The Maritime Silk Road: case report of Neuro-Beh\u00e7et\u2019s disease from Somalia with positive HLA-B51 haplotype. African Journal of Rheumatology. 2022;10:70-73.","journal-title":"African Journal of Rheumatology"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/1752-1947-6-302"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neucir.2019.10.004"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30470-2"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000001729"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/s1474-4422(22)00431-8"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000207481"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2019.05.013"},{"key":"e_1_3_7_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458519898590"},{"key":"e_1_3_7_20_2","doi-asserted-by":"publisher","DOI":"10.1080\/01616412.2021.1949686"},{"key":"e_1_3_7_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_3_7_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_3_7_23_2","unstructured":"World Bank Data Team 2024. New Country Classifications by Income Level: 2023-2024. [Internet][accessed 2025 Apr 30]. Available from: https:\/\/datahelpdesk.worldbank.org\/knowledgebase\/articles\/906519-world-bank-country-and-lending-groups"},{"key":"e_1_3_7_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/s1474-4422(18)30443-5"},{"key":"e_1_3_7_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2024.105555"},{"key":"e_1_3_7_26_2","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000209992"},{"key":"e_1_3_7_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/s1474-4422(19)30488-0"},{"key":"e_1_3_7_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25909"},{"key":"e_1_3_7_29_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000200962"},{"key":"e_1_3_7_30_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458511403643"},{"key":"e_1_3_7_31_2","volume-title":"American Academy of Neurology","author":"Duodu FS","year":"2025","unstructured":"Duodu FS, Alexandra G, Riadh M, et al. Relevance, and feasibility of an online course on multiple sclerosis for african healthcare workers (P4.009). In: American Academy of Neurology. San Diego: Neurology, 2025."},{"key":"e_1_3_7_32_2","unstructured":"WHO and the World Federation of Neurology 2017. Atlas: country resources for neurological disorders 2nd ed. [accessed 2025 May 9] Available from: www.who.int\/publications\/i\/item\/9789241565509"},{"key":"e_1_3_7_33_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2019-314336"},{"key":"e_1_3_7_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2021.120119"},{"key":"e_1_3_7_35_2","unstructured":"Atlas of MS. 3rd edition. 2020. Multiple sclerosis international federation website. [accessed 2025 May 9] Available from: atlasofms.org\/map\/global\/epidemiology\/number-of-people-with-ms."},{"key":"e_1_3_7_36_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.26323"},{"key":"e_1_3_7_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2017.07.037"},{"key":"e_1_3_7_38_2","doi-asserted-by":"publisher","DOI":"10.1212\/nxi.0000000000000505"},{"key":"e_1_3_7_39_2","unstructured":"(IAEA) IAEA. IMAGINE - MRI units (per 1 mil)."},{"key":"e_1_3_7_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmir.2024.101819"},{"key":"e_1_3_7_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2022.09.016"},{"key":"e_1_3_7_42_2","doi-asserted-by":"publisher","DOI":"10.1101\/2022.05.02.22274588"},{"key":"e_1_3_7_43_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-019-09591-8"},{"key":"e_1_3_7_44_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.37833"},{"key":"e_1_3_7_45_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10030463"},{"key":"e_1_3_7_46_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458515599246"},{"key":"e_1_3_7_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2015.06.003"},{"key":"e_1_3_7_48_2","doi-asserted-by":"publisher","DOI":"10.1212\/nxi.0000000000000674"},{"key":"e_1_3_7_49_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2019.01028"},{"key":"e_1_3_7_50_2","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.52178"},{"key":"e_1_3_7_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2022.103716"},{"key":"e_1_3_7_52_2","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.13839"},{"key":"e_1_3_7_53_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.606350"}],"container-title":["Journal of Central Nervous System Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11795735251385319","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11795735251385319","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11795735251385319","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:59:54Z","timestamp":1777391994000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11795735251385319"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":52,"alternative-id":["10.1177\/11795735251385319"],"URL":"https:\/\/doi.org\/10.1177\/11795735251385319","relation":{},"ISSN":["1179-5735","1179-5735"],"issn-type":[{"value":"1179-5735","type":"print"},{"value":"1179-5735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]},"article-number":"11795735251385319"}}