Parkinson’s Disease Diagnosis, Perceptions, Awareness, and Care in Kenya, PACKs WP1 Prevalence of PD

Parkinson's disease (PD) is one of the major neurodegenerative conditions in sub-Saharan Africa (SSA), particularly among aging adults. However, little is known about the epidemiology, service availability, and population-level awareness of PD due to the weak capacity of the primary health care system and PD-related poor knowledge in the SSA setting. There is an apparent lack of data on PD in SSA, including Kenya. This study aims to 1) validate tools for screening, estimate the prevalence of PD at the population level, and assess the knowledge and attitudes of influential community advisors; 2) assess the healthcare service availability and readiness to manage PD, and 3) estimate patient caseloads in neurology clinics and identify barriers and facilitators to diagnosis and referral along the care cascade. The Work package (WP) will employ a concurrent mixed-methods approach, including household surveys nested within APHRC-led Hewlettplanned national surveys among older people in Kenya (n=1500). We will conduct in-depth interviews (n=40) with community health advisors, including traditional healers, community health volunteers, and medicine sellers. WP2 will assess service availability and readiness in three tertiary hospitals, one each from Nairobi and Siaya, and a sample of primary care facilities in Kisumu (n=50) using a systems assessment tool customized for PD. WP3 will estimate patient caseloads in 3 neurology clinics of the selected tertiary hospitals in WP2 and conduct in-depth interviews with PD patient-caregiver dyads (n=45). Focus group discussions (n=3) with patient support groups and caregivers will be conducted. The findings are expected to inform and support community education programs, the development of care models, capacity-building programs for healthcare workers, and policy decisions for improving PD care in SSA.