Table 2 Overview of TraPCAf sub-studies
Research question | Outline of work | Study component | Study details |
|---|---|---|---|
1. What is the prevalence of PD in Africa? | Community, door-to-door prevalence studies in 4 sites | Door-to-door household survey and clinical exam | Community screening and clinical examination. |
2. Are there unique risk factors (genetic and/or environmental) for PD in Africa and are there lessons about PD in general that we can learn from the African perspective? | Exploring the biological mechanisms of PD, conducting genome-wide association and exploring the role of the microbiome and pesticide exposure in PD | a) DNA analysis | Collection and analysis of blood and saliva samples. |
b) Microbiome and metabolite analysis | Collection and analysis of stool and buccal (cheek) samples. | ||
c) Pesticide, heavy metal and trichloroethylene analysis | Collection and analysis of water, soil, and urine samples. | ||
3. How can rates of PD diagnosis be improved? | Development and assessment of aids to diagnosis, including use of screening tools, technologies for gait assessments, and the role of biological samples as possible diagnostic tools | a) Biological diagnostic tools | Collection and analysis of alpha synuclein in blood plasma, blood serum and saliva samples. Collection and analysis of sebum samples. |
b) Technology diagnostic tools | Collection and analysis of gait assessments. Collection and analysis of neuromotor pen data. Collection and analysis of Optical Computerised Tomography (OCT) data. Collection and analysis of smartphone application data. | ||
4. Does the clinical phenotype of PD in Africa differ from what has been reported in other populations? | Phenotype PD using clinically validated scales and understand progression of PD by following up PwP in outpatient settings | a) Clinical assessment | Clinical examination. |
b) Technology for monitoring progression | Collection and analysis of gait assessments. Collection and analysis of smartphone application data. | ||
5. How can the quality of PD management in Africa be improved? | Understanding current management and improving the management of PD through training | a) Economic evaluation | Economic evaluation of current care and services. |
b) Capacity building | Understanding the role of video examination and telemedicine in PD care. Training of healthcare professionals. | ||
6. How can affordable and sustainable treatment for PD be provided in Africa? | Comparing Mucuna Pruriens versus levodopa/carbidopa for the treatment of PD, including an economic evaluation to assess cost-effectiveness | Randomised controlled trial (RCT) | Randomisation to MP or levodopa/carbidopa. Economic evaluation. |
7. What is the current lived experience of people with PD in Africa? | Exploring the lived experience of PD through qualitative interviews, the development of information packages and educational campaigns, and the establishment of support groups | a) Qualitative interviews | Analysis of interviews with PwP, family members and stakeholders. |
b) Community education | Development and evaluation of information packages. Development and evaluation of educational campaigns. | ||
c) Support groups | Development and evaluation of support groups for PD. |