A recent analysis of medical device clinical trials (MDCTs) registered on clinicaltrials.gov highlights significant regional disparities and varying focuses across the African continent. The study, published in Trials Journal, examined 1170 MDCTs to provide insights into the landscape of medical device research and development in Africa, revealing differences in trial volume, health conditions addressed, funding sources, and trial durations.
Regional Distribution of MDCTs
Out of 54 African countries, only 31 had registered MDCTs. Northern Africa leads with 795 trials, primarily driven by Egypt (795). Central Africa recorded the fewest MDCTs (8). South Africa leads Southern Africa (116), and Nigeria leads Western Africa (12). Eastern Africa shows a strong presence, with Uganda (47), Kenya (35), and Tanzania (23) contributing significantly.
Health Conditions Under Investigation
The MDCTs address a wide array of health conditions, including HIV, malaria, tuberculosis, reproductive conditions, infectious diseases, and non-communicable diseases. Northern Africa focuses on dental and male reproductive conditions, non-communicable diseases like diabetes and obesity, and neurodegenerative conditions. Southern and Eastern Africa concentrate on HIV/AIDS, infectious diseases, and circumcision. Eastern Africa has more trials on malaria and neonatal health, while Southern Africa focuses on tuberculosis. Western Africa's trials primarily target malaria and female reproductive conditions. Notably, all regions have MDCTs related to COVID-19.
Trial Status and Funding
Over half of the registered MDCTs (55.3%) have been completed. Western and Central Africa have a higher proportion of completed trials compared to other regions. Many MDCTs (204) are actively recruiting participants across all regions except Central Africa. Funding sources vary, with 79 trials funded exclusively by industry, mainly in Southern and Northern Africa. The US National Institutes of Health (NIH) funds seven MDCTs, primarily in Eastern Africa. Most MDCTs (87.5%) are funded by non-NIH sources, including universities, hospitals, European institutions like the Medical Research Council (MRC), and foundations such as the Bill and Melinda Gates Foundation.
Trial Duration
Southern and Western Africa have a median MDCT duration of 2 years, longer than other regions. Eastern and Northern Africa have a median duration of 1 year. Central Africa's trials typically last longer than the median of 1.5 years. Northern Africa has the highest number of outliers in trial duration, while South Africa has the most significant outliers.
Purpose of Devices Under Trial
The majority of devices undergoing clinical trials are for treatment purposes (715), particularly for oral and skeletal health. Devices for prevention (201) and diagnostics (144) are also prominent. Prevention devices target HIV, infections, female reproductive issues, and circumcision. Diagnostic devices focus on tuberculosis, HIV, malaria, and female reproductive conditions.
