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

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

► To cite this version:

Callixte Kuate-Tegueu, Pierre Waffo-Téguo, Nadine Simo, Maturin Tabue-Teguo. Promote a new paradigm to prevent neurodegenerative disease in sub-Saharan Africa. The Pan African Medical Journal, 2020, 36, pp.1-2. 10.11604/pamj.2020.36.138.21881. hal-02926000

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Distributed under a Creative Commons Attribution 4.0 International License
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Letter to the editors

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# 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, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon. tabue.maturin@gmail.com

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

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

**Copyright:** 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). 10.11604/pamj.2020.36.138.21881

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

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

Callixte Kuate-Tegueu<fnref n="1" />, Pierre Waffo-Teguo², Nadine Simo³, Maturin Tabue-Teguo³,⁴,⁸

⁸**Corresponding author**

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

<footnote n="1">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</footnote>
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To the editors of the Pan African
Medical Journal

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
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vast African region with a population of 1.1 billion
people and a steadily increasing number of elders
 projec ted 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

The authors declare no competing interests.

Authors´ contributions

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.

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