Multiple Sclerosis in sub-Saharan Africa – a scoping review

Background: The objective of this review is to provide a synthesis of original studies in patients with MS, originating from sub-Saharan Africa. This review aims to facilitate a better understanding of the MS academic and health landscape in this region. Methods: A scoping review of original research was conducted (20^th of November 2019) in PubMed, SCOPUS, Web of Science and EBSCO host. A narrative synthesis of studies was provided and placed in a historical context. Results: Thirty-one unique studies from sub-Saharan Africa were identified from 846 unique records. The included studies were predominantly conducted in South Africa (n=24;[77%]) and of case-control (n=11[36%]) or cross-sectional design (n=7[23%]); no randomized clinical trials were identified. Most studies focussed on understanding the epidemiology of MS, the risk of MS in specific ethnic populations, and how this may contribute to identifying the underlying causal pathways. Conclusion: Albeit scarce, the research conducted in sub-Saharan Africa largely followed international trends. There is a paucity of studies that have been conducted with the primary aim of understanding MS patient care across the continuum, and management of MS in an African context. The latter may become of increasing importance in the light of an increasing prevalence of MS in this region, as well as the increasing noncommunicable disease epidemic.