AA Amyloidosis in Africa: Epidemiology, Etiologies, Diagnostic Gaps, and Therapeutic Perspectives

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healthcare

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paper

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Gha

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ABSTRACT This review synthesizes epidemiological data from Algeria (378 cases), Tunisia (310 cases), Morocco (30 cases), Egypt (40 cases) and sub‑Saharan Africa (autopsy incidence 0.28‑0.57%). Tuberculosis remains the leading cause in all Maghreb countries, while Algeria shows a documented increase in autoinflammatory diseases; familial Mediterranean fever (FMF) predominates as the leading cause in Egypt. Diagnostic gaps include the absence of mass spectrometry in all African countries, limited anti‑AA immunohistochemistry in sub‑Saharan Africa, and no routine SAP scintigraphy. Therapeutic access is highly contrasted: adalimumab is available in several Maghreb countries, anakinra in Algeria (TRAPS approval 2025), and canakinumab is virtually absent. We propose national registries (based on the Egyptian FMF registry and the Armenian NAREG model), South‑North telepathology, and expanded access to biotherapies through biosimilars. Keywords: AA amyloidosis, Africa, diagnosis, SAP scintigraphy, Congo red, tuberculosis, FMF, autoinflammatory diseases, biotherapies.

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