Congress of the Neurological Association of South Africa, 2020

Nfwama Kawatu, MD, University Teaching Hospitals-Children's Hospital, Lusaka, Zambia, and Kafula Lisa Nkole, MD, University Teaching Hospitals-Children's Hospital, Lusaka, Zambia

Introduction

The Neurological Association of South Africa (NASA) held its annual congress in Cape Town, South Africa, from March 12–15, 2020. This year’s event attracted over 400 delegates and speakers from across Africa and other continents making it the largest congress in the history of NASA.

Location and Venue

Located in the world famous Cape Town wine lands, in the vicinity of the Helderberg Mountains and the Atlantic Ocean, the NH Lord Charles Hotel was a beautiful and well equipped venue to host this year’s NASA congress. The location offered a lot of activities and a spectacular scenery for all the visitors. The rooms were clean and comfortable with an almost victorian ambience that, coupled with a beautiful view of the gardens offered a rather relaxing experience.

The congress facilities were clean and air-conditioned and delegates had access to water and coffee throughout the sessions.

Speakers and Delegates

Delegates in attendance hailed largely from across Africa represented by neurologists, neurology registrars, researchers, psychologists, and psychiatrists. There was a perfect balance between the local (South African) and international speakers/ faculty who are world renowned academicians and researchers in the various disciplines of neurology spanning from neuro-immunology, neuro-infections, neuro-radiology, to stroke. Some of the international speakers included Professor Tom Solomon (UK), Professor Abd- Allah (Egypt), Professor Jackie Palace (UK), Professor Rustam Al Shahi-Salman (Scotland), Professor Jon Stone (Scotland) and Dr. Deanna Saylor (USA). South Africa was well represented by Professors Lawrence Tucker and Jeanine Hackman, and many others.

Program

The congress kicked off with pre-congress workshops on movement disorders, sleep, and the use of immunosuppressive treatment for various neurological disorders. There were a lot of platform presentations on various neurology subjects backed by well-researched evidence based clinical data, but some that stood out where:

  • Aetiology, Mechanism, Diagnosis and Management of Functional Neurological Disorders (FND).

These series of presentations delivered by Professor Jon Stone (Scotland), highlighted the pivotal task that neurologists play in managing patients with FND and emphasised the role of multidisciplinary effort in dealing with people living with this condition. FND is a real challenge for both the patient and the physician, and can cause a remarkable loss of life years

  • Tackling brain infections globally, so eloquently presented by Professor Tom Solomon brought to light the diverse presentation of CNS infections, i.e. Dengue fever, Japanese encephalitis, and subacute sclerosing panencephalitis (SSPE), using clinical cases that were particularly interesting especially for the neurology registrars in attendance.
  • Professor Jackie Palace (UK) gave a series of thought provoking talks on neuromyelitis optica spectrum disorders (NMOSD) and Multiple Sclerosis, highlighting the diagnostic differences between these two conditions. Her presentation “How I approach the management of NMO” outlined a very robust management strategy for NMO targeting therapeutic options of acute attacks aimed at preventing severe and permanent disabilities and management options that can be used to prevent recurrent attacks of NMO.
  • Dr. Deanna Saylor presented on her journey to creating a neurology training program in Zambia and advocating for more neurologist across Africa to meet the high burden of neurological diseases in this region. This program, aimed at mitigating the critical shortage of these specialists, is training the first cohort of Zambian neurologists in both adult and paediatric neurology.
  • Other topics covered included management of intracerebral hemorrhage, running effective stroke units in resource limited settings, medicinal use of cannabinoids, dementia, and myasthenia gravis.
  • To conclude the congress, there was a session for private practitioners in South Africa as regards the practicalities and ethics of neurological procedure coding and funding practices.
  • The poster presentation session showcased diverse research and case reports from across the continent. Particularly from the Zambian neurology residents, five poster presentations were accepted. These included studies on adult stroke (prevalence, risk factors, types of stroke, HIV and non-HIV associated stroke), neurosyphilis and the presence of patients with multiple sclerosis in Zambia. Other posters of note were from the host country's neurology residents. They varied from topics like the genetics of steroid resistant ptosis in myasthenia gravis to rare neurological cases.

 Lessons learned

  • Africa requires more neurology training programs in order to cater for the huge burden of neurological disease.
  • Collaborative efforts are necessary to strengthen research, clinical knowledge, and skills as evidenced by the assortment of delegates/speakers that attended the congress.

Recommendations

  • More topics from the child neurology perspective to be considered for future NASA congresses.

We would like to thank the everyone who made it possible for us to attend the congress. Sincere thanks to the Encephalitis Society for supporting the Zambia Neurology Program.