Management Practice and Clinical Outcomes of Dementia in Sub-Saharan Africa: A Systematic Review

Table 1

Summary of RCTs and prospective cohort included in the analysis, 2021.

S. no	Study design	Subjects		Study purpose	Interventions	Duration of study	Dementia types/etiologies	Outcomes evaluated	Country	Authors, year	Conclusions of authors
		Control	Experimental/exposure
1	RCT	642	9	Feasibility and clinical effectiveness of CST	Asses quality of life using the WHOQOL-BREF	7 weeks	Alzheimer’s disease	Improvements in cognitive function and quality of life after CST intervention	Nigeria	Olakehinde et al., 2019	CST appears to be feasible in this setting.
2	RCT	466	34	Feasibility and clinical effectiveness of CST	Assess the changes in quality of life (QoL) by using WHOQOL-BREF	20 weeks	Alzheimer’s disease	Change in QoL and cognition after CST intervention	Tanzania	Paddick et al., 2015	Intervention has the potential to be low-cost, sustainable, and adaptable to other settings across SSA.
3	RCT	—	94	The diagnostic accuracy of IHDS-HCSQ; With HAND.	Administered the diagnostic accuracy of IHDS-HCSQ with HAND.	—	HAND	Cognitive screening tools might successfully discriminate; The most severe form of HAND	South Africa	Gouse et al., 2017	IHDS-HCSQ combination offers a viable and quick way to screen people living with HIV for HAND. It can deliver excellent sensitivity and good specificity.
4	RCT	—	1036	Neurocognitive function at the first-line cART failure and change on the second-line therapy	Administered second-line therapy and test neurocognitive function at baseline, 48 and 96 weeks	96 weeks	HAND	Improved neurocognitive function after the administration of second-line therapy	5 SSA countries	Kambugu et al., 2016	Patients in SSA failing the first-line cART had low neurocognitive function test scores, but performance improved on the second-line cART.
5	Cohort	—	277*	Identification and intervention for dementia in elderly Africans cognitive screen	Administered IDEA cognitive screen tool	—	Alzheimer’s disease	Validation of the IDEA cognitive screen tool in SSA	Nigeria, Tanzania	Paddick et al., 2015	The IDEA cognitive screen performed well in these populations and should prove useful in screening for dementia and delirium in other areas of SSA
6	RCT	36	37	Efficacy and safety of minocycline in the management of HAND.	Receive 100 mg of minocycline orally every 12 hours for 24 weeks	24 weeks	HAND	Change in neurocognitive performance from baseline to 24 weeks	Uganda	Nakasujja et al., 2013	It did not improve HIV-associated cognitive impairment
7	Cohort	25	102*	Benefits and risks of stavudine-based cART for HAND	Initiation of the stavudine-based cART	24 weeks	HAND	Improvement in verbal memory, motor and psychomotor speed, executive thinking, and verbal fluency	Uganda	Sacktor et al., 2009	After the initiation of cART, including stavudine, HIV individuals with cognitive impairment improve significantly as demonstrated by improved performance on a test of executive function
8	Cohort	—	23*	Neuropsychological test and functional performance in HIV individuals after 3 and 6 months of cART	Initiation of cART		HAND	Neurocognitive at 3 and 6 months after initiation of cART	Uganda	Sacktor et al., 2006	cART can be associated with improvement in neurocognitive and functional performance in HIV individuals in SSA

*Indicated the Cohort study design.