How Geography, Healthcare Systems and Access Shape the Multiple Sclerosis Journey

Let's start at the very beginning of an MS journey diagnosis.

So Alfredo obviously coming from Brazil, Fifi coming from Ghana.

we're going to suspect that potentially there are differences in terms of the diagnostic journey of someone who's suspected to have MS in your regions.

So let's start with that.

What are some barriers that might exist to a quick diagnosis? How has this been impacted by the new diagnostic criteria? And just what does that journey look like for a person in your part of the world? If you can start, please.

Sure, thank you Alfredo.

So thank you very much for the question.

Really when it comes to MS diagnosis and the journey could be quite long in a part of the world in Ghana.

I started by setting up a registry and I realized that on the average my patients take at least five years to get diagnosis from the first sentinel set to the time diagnosis made by a neurologist.

And also as I was quite similar across the sub region in another part of sub-Saharan Africa.

And these are because of the barriers they face before they finally get a diagnosis.

Majority of them, though, there might be three from the patient side, the health professional, and then systemic failure.

From the patient side, there's a lot of lack of awareness in terms of even the symptoms of MS and pinning them together.

Some think it might be spiritual because they move from one doctor to another and it's not really telling them what it is.

And every time their diagnosis keeps changing from one neurological thing to something else.

So it's quite difficult.

And so some actually even give up and look for alternative medicine.

When it comes to the health professional side, especially, there's a big issue when it comes to neurologists in our part of the world.

You know, we have about neurologist population about 0.03 to 100,000 population in South Africa, which is a very big problem.

And so most of these patients are seen by non-neurologists, like many general practitioners and ophthalmologists.

And some also realize that the lack of awareness of MS symptoms is really lacking in these doctors, and so they cannot pin things together or even ask for if you had this in the past before.

So it takes a very long time.

Eventually, they do end up being referred to see a neurologist who says, oh, I think all this has been having has been multiple sclerosis and it's taking this long.

Do you have a patient? I saw it took 13 years.

to eventually being diagnosed with multiple sclerosis.