Letter to the editors | Volume 36, Article 138, 29 Jun 2020 | 10.11604/pamj.2020.36.138.21881

Promote a new paradigm to prevent neurodegenerative disease in sub-Saharan Africa

Callixte Kuate-Tegueu, Pierre Waffo-Teguo, Nadine Simo, Maturin Tabue-Teguo

Corresponding author: Maturin Tabue-Teguo, Université de Guadeloupe, Centre Hospitalier Universitaire de Pointe-à-Pitre, Les Abymes, France

Received: 19 Feb 2020 - Accepted: 14 Mar 2020 - Published: 29 Jun 2020

Domain: Epidemiology,Geriatrics,Geriatric Neurology

Keywords: Cohort study, epidemiology, neurodegenerative disease, sub-Saharan-Africa (SSA)

©Callixte Kuate-Tegueu et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite this article: Callixte Kuate-Tegueu et al. Promote a new paradigm to prevent neurodegenerative disease in sub-Saharan Africa. Pan African Medical Journal. 2020;36:138. [doi: 10.11604/pamj.2020.36.138.21881]

Available online at: https://www.panafrican-med-journal.com/content/article/36/138/full

Home | Volume 36 | Article number 138

Letter to the editors

Promote a new paradigm to prevent neurodegenerative disease in sub-Saharan Africa

Promote a new paradigm to prevent neurodegenerative disease in sub-Saharan Africa

Callixte Kuate-Tegueu1, Pierre Waffo-Teguo2, Nadine Simo3, Maturin Tabue-Teguo3,4,&

 

1Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon, 2Institut des Sciences de la Vigne et du Vin, EA 4577, USC1366 INRA, IPB, Université de Bordeaux, Bordeaux, France, 3Université de Guadeloupe, Centre Hospitalier Universitaire de Pointe-à-Pitre, Les Abymes, France, 4INSERM U 1219, Université de Bordeaux, Bordeaux, France

 

 

&Corresponding author
Maturin Tabue-Teguo, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon

 

 

To the editors of the Pan African Medical Journal    Down

Prevention is the corner stone when dealing with disability as it must be considered as a nearly irreversible condition in elderly people. There is a growing demand for the identification of effective solutions against the detrimental consequences that age-related conditions (in particular, disabilities) exert on our healthcare systems. Therefore, preventive interventions able to modify the natural history of age-related conditions are urgently needed. Nutritional interventions appear to be a potentially effective way to prevent dementia in high income countries. The promotion of a healthy lifestyle and the adoption of preventive countermeasures for a specific condition are quite challenging. The approach based on the use of local natural resources such as diversified and rich food must be explored in sub-Saharan-Africa (SSA).

Dementia: a global public health priority: as demographics in developed nations shift towards an aging population, neurodegenerative pathologies pose one of the largest challenges to the modern health care system [1]. Neurodegenerative diseases are a growing health concern. The increasing incidences of these disorders have a great impact on the patients' quality of life [2]. The most common neurodegenerative diseases are Alzheimer´s disease and Parkinson´s disease, but also include other conditions like amyotrophic lateral sclerosis and others dementia. These conditions are often debilitating, not just for the individual diagnosed but for his or her entire family, social network and health care system. To this project, we are focused on Alzheimer´s disease as neurodegenerative diseases. Alzheimer´s disease (AD) is a progressive neurodegenerative disorder that accounts for the major cause of dementia in the world. The number of cases is projected to reach 106.8 million worldwide by the year 2050. Therefore, the disease is a growing public health concern with major socioeconomic burden [2]. Much attention has been paid to disease-modifying factors and risk factors for AD [3]. Little is known about the natural history, clinical pattern, etiologies and treatment status of AD in elderly people in sub-Saharan-Africa. In this region, data about the prevalence of neurodegenerative pathologies are scarce and largely coming from Central and Western Africa [4-6]. The reported age-adjusted prevalence of dementia for the population-based studies in SSA varied widely, ranging from 2.3% to 7.6%. Many risk factors of neurodegenerative pathologies have been highlighted, leaving a door open towards prevention.

Importance of prevention for neurodegenerative disease: prevention is the corner stone when dealing with disability as it must be considered as a nearly irreversible condition in elderly people. There is a growing demand for the identification of effective solutions against the detrimental consequences that age-related conditions (in particular, disabilities) exert on our healthcare systems. Therefore, preventive interventions able to modify the natural history of age-related conditions are urgently needed. In this last decade, a relevant body of scientific literature has increasingly been advocated the need of implementing preventive actions against age-related and disabling conditions in the elderly in high income countries. Current treatments given after dementia diagnosis have demonstrated only modest efficacy. Taking into account the failure of these curative therapies, it seems reasonable to evaluate another strategy in patient´s management such as possibility of preventive intervention that could reduce the rate of conversion to dementia among subjects at high risk [7-9]. Nutritional interventions appear to be a potentially effective way to prevent dementia [10] in high income countries.

Suggestions to implement neurodegenerative disease prevention interventions in SSA: to our knowledge, no epidemiological study nor clinical trial has yet reported the implementation prevention intervention against neurodegenerative disease in SSA, which still is a vast African region with a population of 1.1 billion people and a steadily increasing number of elders (projected to be over 67 million by 2030 [11]). The allocation of economic resources in the field of prevention (for any kind of legitimate clinical condition) may raise special issues, especially in SSA. In these regions where economic difficulties may already affect the condition of optimal healthcare services, the development of novel infrastructures dedicated to preventive medicine might be difficult. Thus, the legislator may find himself at balancing the costs of prevention with those necessary for assuring the sustainability of the traditional clinical care services. Such decision may potentially foster ethical discussions. The activities aimed at informing the general population about the risk of disabling conditions at old age are necessary but inevitably expensive, challenging their feasibility especially in SSA. Moreover, the promotion of a healthy lifestyle and the adoption of preventive countermeasures for a specific condition are quite challenging. For this reasons, an approach based on the use of local natural resources such as diversified and rich food must be explored in SSA. One of the candidate is Gnetum africanum, popular food plants in tropical Africa. Gnetum africanum is a liana that grows abundantly in Central Africa. Leaves are eaten as raw vegetables or in soups by local people. It is known as “Eru or Kok” in Cameroon. The leaves are also used for their nutritional and medicinal properties[12]. G. africanum is a rich source of health promoting compounds, including flavonoids, phenolic acids, and stilbenoids [12-14]. The stilbenoid monomer resveratrol has undergone extensive biological testing, particularly in regard to disease prevention and anti-aging activities [15-17]. Cameroon has launched a program to support the cultivation of G. africanum, which has produced more than 3 million plants and trained more than five million people. We plan a study whose aim will be to determine the relationship between sociodemographic factors, G. africanum intake, and the presence of neurodegenerative disease and secondary frailty in people from Cameroon, a Central African country. The result of this study may lead to a possible preventive effect of African antioxidants rich foods by reducing cognitive decline. In other hand, the identification of frail older persons is a public health priority. Frailty is defined as an extreme vulnerability of the organism to endogenous and exogenous stressors, a syndrome that exposes the individual at higher risk of negative health-related outcomes as well as a transition phase between successful aging and disability. The theoretical concept of frailty is largely agreed, its practical translation still presents some limitations due to the existence of multiple tools and operational definition Theses interventions should be developed against frailty and the resulting effects of ageing [11].

 

 

Competing interests    Down

The authors declare no competing interests.

 

 

Authors´ contributions Up    Down

Kuate-Tegueu Callixte, Waffo-Teguo Pierre, Nadine Simo and Tabue-Teguo Maturin: study, conception and design, drafting of the manuscript and critical revision. All authors have read and agreed to the final version of this manuscript.

 

 

References Up    Down

  1. Gillette-Guyonnet S, Secher M, Vellas B. Nutrition and neurodegeneration: epidemiological evidence and challenges for future research. Br J Clin Pharmacol. 2013 Mar;75(3):738-55. PubMed | Google Scholar

  2. Brookmeyer R, Johnson E, Ziegler-Graham K, Arrighi HM. Forecasting the global burden of Alzheimer´s disease. Alzheimers Dement. 2007 Jul;3(3):186-91. PubMed | Google Scholar

  3. Jiang T, Yu J-T, Tan L. Novel disease-modifying therapies for Alzheimer´s disease. J Alzheimers Dis. 2012;31(3):475-92. PubMed | Google Scholar

  4. Callixte Kuete-Tebeu, Benjamin Clet, Jacques Doumbe, Faustin Yepnjio, Jean François Dartigues, Maturin Tabue-Teguo. The pattern of neurological diseases in elderly people in outpatient consultations in Sub-Saharan Africa. BMC Res Notes. 2015 Apr 17;8:159. PubMed | Google Scholar

  5. Moussiliou N Paraïso, Maëlenn Guerchet, Jacques Saizonou, Pascale Cowppli-Bony, Alain M Mouanga, Philippe Nubukpo et al. Prevalence of dementia among elderly people living in Cotonou, an urban area of Benin (West Africa). Neuroepidemiology. 2011;36(4):245-51. PubMed | Google Scholar

  6. Maëlenn Guerchet, Pascal Mbelesso, Bébène Ndamba-Bandzouzi, Sophie Pilleron, Ileana Desormais, Philippe Lacroixet al. Epidemiology of dementia in Central Africa (EPIDEMCA): protocol for a multicentre population-based study in rural and urban areas of the Central African Republic and the Republic of Congo. Springerplus. 2014 Jul 3;3(1):338. PubMed | Google Scholar

  7. Andrieu S, Guyonnet S, Coley N, Cantet C, Bonnefoy M, Bordes S et al. Effect of long-term omega 3 polyunsaturated fatty acid supplementation with or without multidomain intervention on cognitive function in elderly adults with memory complaints (MAPT): a randomised, placebo-controlled trial. Lancet Neurol. 2017 May; 16(5):377-389. PubMed | Google Scholar

  8. Tii Ngandu, Jenni Lehtisal, Alina Solomon, Esko Levälahti, Satu Ahtiluoto, Riitta Antikainen et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet Lond Engl. 2015; 385: 2255-63. Google Scholar

  9. Moll van Charante EP, Richard E, Eurelings LS, van Dalen JW, Ligthart SA, van Bussel EF et al. Effectiveness of a 6-year multidomain vascular care intervention to prevent dementia (preDIVA): a cluster-randomised controlled trial. Lancet. 2016 Aug 20;388(10046):797-805. PubMed | Google Scholar

  10. Shah R. The role of nutrition and diet in Alzheimer disease: a systematic review. J Am Med Dir Assoc. 2013 Jun;14(6):398-402 PubMed | Google Scholar

  11. Maturin Tabue Teguo, Callixte Kuate-Tegueu, Jean-François Dartigues, Matteo Cesari. Frailty in sub-Saharan Africa. Lancet. 2015 May 30;385(9983):2151. PubMed | Google Scholar

  12. Fadi Ali, Mafu Akier Assanta, Carole Robert. Gnetum africanum: a wild food plant from the African forest with many nutritional and medicinal properties. J Med Food. 2011 Nov;14(11):1289-97. PubMed | Google Scholar

  13. Thierry Buffeteau, Dominique Cavagnat, Jonathan Bisson, Axel Marchal, Gilbert Kapche, Ilaria Battistini et al. Unambiguous determination of the absolute configuration of dimeric stilbene glucosides from the rhizomes of gnetum africanum. J Nat Prod. 2014 Aug 22;77(8):1981-5. PubMed | Google Scholar

  14. Moise Mvitu-Muaka, Benjamin Longo-Mbenza, Etienne Mokondjimobe, Thierry Gombet, Dalida Kibokela Ndembe, Doris Tulomba Mona et al. Intake of gnetum africanum and Dacryodes edulis, imbalance of oxidant/antioxidant status and prevalence of diabetic retinopathy in central Africans. PLoS One. 2012;7(12):e49411 PubMed | Google Scholar

  15. Espinoza JL, Inaoka PT. Gnetin-C and other resveratrol oligomers with cancer chemopreventive potential. Ann NY Acad Sci. 2017 Sep;1403(1):5-14. PubMed | Google Scholar

  16. Shraddha Rege, Thangiah Geetha, Gerald Griffin, Tom Broderick, Jeganathan Ramesh Babu. Neuroprotective effects of resveratrol in Alzheimer disease pathology. Front Aging Neurosci. 2014 Sep 11;6:218. PubMed | Google Scholar

  17. Gordon Cragg, Paul Grothaus, David Newman. New Horizons for Old Drugs and Drug Leads. J Nat Prod. 2014 Mar 28;77(3):703-23. PubMed | Google Scholar

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Letter to the editors

Promote a new paradigm to prevent neurodegenerative disease in sub-Saharan Africa

Letter to the editors

Promote a new paradigm to prevent neurodegenerative disease in sub-Saharan Africa

Letter to the editors

Promote a new paradigm to prevent neurodegenerative disease in sub-Saharan Africa

Volume 36 (May - Aug 2020)
This article authors
On Pubmed
On Google Scholar
Citation [Download]
EndNote
Reference Manager
Zotero
BibTex
ProCite

Navigate this article
Key words

Cohort study

Epidemiology

Neurodegenerative disease

Sub-Saharan-Africa (SSA)

PlumX Metrics
Promote a new paradigm to prevent neurodegenerative disease in sub-Saharan Africa