Mapping evidence on Awareness, Knowledge and Risk Perception of Multiple Myeloma (MM) in Africa: A Scoping Review

Celenkosini Thembelenkosini Nxumalo; Hlolisile Chiya; Sibongile Ramotshela; Usangiphile Buthelezi; Zamasomi Luvuno

doi:10.12688/f1000research.178123.1

Home Browse Mapping evidence on Awareness, Knowledge and Risk Perception of Multiple...

ALL Metrics

-

Views

-

Downloads

Get PDF

Get XML

Export

▬

✚

Systematic Review

Mapping evidence on Awareness, Knowledge and Risk Perception of Multiple Myeloma (MM) in Africa: A Scoping Review

[version 1; peer review: awaiting peer review]

Celenkosini Thembelenkosini Nxumalo ^1,2, Hlolisile Chiya², Sibongile Ramotshela³, Usangiphile Buthelezi⁴, Zamasomi Luvuno⁴

Celenkosini Thembelenkosini Nxumalo ^1,2, Hlolisile Chiya², [...] Sibongile Ramotshela³, Usangiphile Buthelezi⁴, Zamasomi Luvuno⁴

PUBLISHED 08 Jun 2026

Author details Author details

¹ Research Development and Postgraduate Support, Office of the DVC Research and Innovation, University of the Western Cape, Bellville, Western Cape, South Africa
² Discipline of Nursing, University of KwaZulu-Natal School of Nursing and Public Health, Durban, KwaZulu-Natal, South Africa
³ AFIA TIA, Non-Profit Organisation, Durban, KwaZulu-Natal, South Africa
⁴ Centre for Rural Health, University of KwaZulu-Natal School of Nursing and Public Health, Durban, KwaZulu-Natal, South Africa

Celenkosini Thembelenkosini Nxumalo
Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Validation, Writing – Original Draft Preparation, Writing – Review & Editing

Hlolisile Chiya
Roles: Resources, Validation, Writing – Original Draft Preparation, Writing – Review & Editing

Sibongile Ramotshela
Roles: Funding Acquisition, Investigation, Validation, Writing – Review & Editing

Usangiphile Buthelezi
Roles: Formal Analysis, Project Administration, Validation, Writing – Review & Editing

Zamasomi Luvuno
Roles: Conceptualization, Funding Acquisition, Investigation, Resources, Validation, Writing – Review & Editing

OPEN PEER REVIEW

REVIEWER STATUS AWAITING PEER REVIEW

This article is included in the Oncology gateway.

Abstract

Background

Multiple Myeloma (MM) is characterized by the abnormal accumulation of plasma cells in the bone marrow. While the precise epidemiology of MM remains relatively unclear in Africa, its incidence and prevalence continue to rise. Primary prevention is key to effectively managing MM in Africa, due to resource constraints that account for the prevailing disparities in diagnosis and treatment. A comprehensive understanding of current awareness, knowledge and risk perception of MM is thus crucial for the design and implementation of contextually relevant preventive strategies.

Aim

This scoping review maps evidence on the awareness, knowledge and risk perceptions of MM in Africa.

Methods

The Arksey and O’Malley framework guided the review process. Electronic databases, namely PubMed, Scopus, CINHAL, Web of Science, and SA-ePublications, were searched to identify relevant research articles. The results are reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram.

Results

The initial search yielded 204 studies; after duplicate removal, title and abstract screening, 18 articles were included for full-text review to ascertain eligibility. Eight articles were eventually included in the final review.

Conclusion

The review reveals a paucity of empirical studies on knowledge, awareness and risk perception of MM in Africa. Generally, current research indicates low levels of knowledge and awareness of MM among healthcare workers. The extant research and reported low levels of awareness may account for the delay in diagnosis and management of the condition, which has consequences for public health and quality of life in the region. Research is urgently required to address prevailing knowledge gaps so that appropriate interventions may be implemented to address current challenges with early detection of MM in Africa.

Keywords

Awareness, Hematological Malignancies, Knowledge, Multiple Myeloma, Risk Perception

Corresponding author: Celenkosini Thembelenkosini Nxumalo

Competing interests: No competing interests were disclosed.

Grant information: The research reported in this article was funded by the Bristol Myers Squibb Foundation. The content is solely the responsibility of the authors and does not necessarily represent the official views of funder or affiliation of the authors.
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Copyright: © 2026 Thembelenkosini Nxumalo C et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to cite: Thembelenkosini Nxumalo C, Chiya H, Ramotshela S et al. Mapping evidence on Awareness, Knowledge and Risk Perception of Multiple Myeloma (MM) in Africa: A Scoping Review [version 1; peer review: awaiting peer review]. F1000Research 2026, 15:889 (https://doi.org/10.12688/f1000research.178123.1) First published: 08 Jun 2026, 15:889 (https://doi.org/10.12688/f1000research.178123.1) Latest published: 08 Jun 2026, 15:889 (https://doi.org/10.12688/f1000research.178123.1)

Background

Multiple Myeloma (MM) develops from the accumulation and proliferation of abnormal plasma cells in the bone marrow.¹ These cells can be benign or malignant, but ultimately damage the bone marrow, affecting blood vessel growth and leading to localized and systemic complications. Multiple Myeloma usually begins as a monoclonal gammopathy of uncertain significance, which is often asymptomatic.² When symptoms do occur, typical clinical signs of MM include low hemoglobin, proteinuria, bone pain, and hypercalcemia.³ Global epidemiological data indicate that the age-standardized incidence rate (ASR) was 78 (95% UI 69–87) per 100,000 people, and the mortality rate was 14 (95% UI 07–21) per 100,000 people in 2020.⁴ Research also shows that MM is the second most common hematological malignancy, primarily affecting older males over 65, with significant impacts on quality of life.^5,6

The cause of MM remains relatively unclear; however, it is suggested that genetic changes and a combination of lifestyle factors, such as alcohol use, obesity, and exposure to harmful radiation, insecticides, and other toxic chemicals, may be linked to MM.^7,8 It has been reported that the survival rate among patients with MM has improved significantly over the years, due to advances in treatment, including new drug therapies, autologous stem cell transplants, and improved supportive care.^9,10 Despite progress in treatment options for MM, accurate and timely diagnosis of the condition remains difficult, with poorer outcomes reported in cases of late diagnosis.^11,12 Early detection of MM is essential for ensuring the best possible quality of life and higher patient survival rates. This, in turn, depends on healthcare workers and the public having accurate knowledge of the clinical signs of the condition and a higher index of suspicion. Educating both the public and healthcare professionals is therefore a key strategy for ensuring timely diagnosis and treatment.¹³

In low- to middle-income regions like Africa, the prevalence and incidence of MM are reportedly rising. Although the precise epidemiology of the condition remains unclear in the region, it is estimated that the prevalence is twice as high among Africans compared to Caucasians.¹⁴ In Nigeria, MM is estimated to constitute between 5.6% and 12.9% of hematological malignancies, ranking behind chronic myeloid leukemia, non-Hodgkin’s lymphoma, and chronic lymphocytic leukemia in frequency.¹⁵ In South Africa, a total of 3603 incident cases were reported between 2004 and 2013. Additionally, mature lymphoid malignancies accounted for approximately 60% (n = 2153), myeloma/plasma cell neoplasms 13% (n = 465), acute leukemia 17% (n = 596), chronic myeloid leukemia 4% (n = 155), and other myeloproliferative neoplasms 6% (n = 234) when categorized according to conventional groups.¹⁶ The lack of routine, reliable data sources that provide detailed epidemiology hinders the development of targeted interventions for effective management of the disease across prevention, promotion, treatment, and palliative care.

The African region also bears a disproportionately high burden of disease, including HIV/AIDS, mental health issues and substance abuse, violence and injury, malaria, tuberculosis, and other non-communicable diseases such as hypertension, diabetes, and other cardiovascular conditions.^14,15 The increasing rates of cancers such as MM place significant pressure on the healthcare system in terms of financial resources, infrastructure, and human capacity to effectively meet the population’s health needs.¹⁶ The health resources of low- to middle-income countries are also reported to be severely strained due to inadequate infrastructure and limited financial resources, which are linked to poor socio-economic conditions in the region.¹⁷ As a result, the rising prevalence and incidence of MM in this region are expected to pose challenges that may affect the quality of health service delivery and health outcomes, given these existing obstacles.

In most regions of Africa, particularly South Africa, health services are delivered through a primary health care approach, with the district health system used as a vehicle to ensure equitable service delivery for all.¹⁸ In line with the principles of primary healthcare, services must encompass preventive, promotive, curative, palliative, and rehabilitative aspects, with primary healthcare and community-based centres as the entry points for health service delivery.¹⁹ In the context of a rapid increase in multimorbid conditions in the general population, health promotion through prevention remains instrumental for disease control.

Current research on MM in Africa remains limited to clinical studies, case reports, reviews and expert opinion articles.^20–24 Moreover, studies on awareness, knowledge and perceptions of MM have predominantly been conducted in the global north, particularly in Europe, the USA and certain regions of China. These research studies provide empirical evidence of patient and caregiver understanding of diagnosis²⁵ and knowledge, attitudes and practices of medical doctors towards MM.²⁶ A prospective study conducted to promote a public health campaign on Awareness and Screening for MM in Nigeria, revealed low levels of knowledge about the condition among healthcare workers and the general public.²⁷ Some scholars have argued that current challenges with diagnosis and treatment of MM may be attributed to lack of knowledge and skills about the condition and general infrastructure challenges in Africa.²⁰ Rising incidence of MM in Africa and the related challenges with early diagnosis requires appropriate preventative strategies to respond sustainably to address its health implications and the subsequent cost of healthcare treatment that will be incurred. These strategies should encompass public education campaigns, screening and early detection to reduce the disease burden of MM.²⁸

A baseline, holistic, and comprehensive understanding of awareness, risk perception, and MM knowledge at the population level is therefore necessary. This information may support the development of tailored messaging on causes, prevention, treatment options, and relevant care pathways for managing the condition. This scoping review thus seeks to map evidence on the awareness, knowledge and risk perceptions of MM in Africa, highlighting current challenges and research gaps to inform current clinical practice and further research.

Methods

This scoping review mapped evidence on the awareness, knowledge, and risk perception of MM in Africa. The authors used the framework by Arksey and O’Malley²⁹ to guide the review process. The review thus comprised of the following steps: (1) identification of the review question, (2) identification of the relevant studies, (3) selection of relevant studies, (4) charting the data, (5) collating, summarizing and reporting the results.

Identification of the review question

The main review question was: “What is the range of literature on awareness, knowledge and risk perception of MM in Africa?”

The sub-review questions were:

1. What is the range of evidence on the awareness, knowledge and risk perception of MM in Africa?
2. What literature exists on recommendations to support awareness, knowledge and risk perception of MM in Africa?
3. What are the existing research gaps in research on the awareness, knowledge and risk perceptions of MM in Africa?

Identification of the relevant studies

Relevant keywords were used in conjunction with Boolean operators to search for published research articles in electronic databases, namely PubMed, Scopus, CINHAL, Web of Science, and SA-ePublications. The comprehensive search strategy was developed by the authors in collaboration with a subject librarian to ensure the correct use of indexing terminology. The search strategy was subsequently piloted in PubMed to determine its relevance and applicability for the review. Details of search terms and the combination of Boolean operators used are detailed in Table 1.

Table 1. Search strategy.

Database	Search Terms used	Articles Retrieved
PubMed	Awareness OR Knowledge OR “Risk Perception” OR perception OR “Perceived risk” OR “Risk appraisal” OR “Risk assessment” OR “Perceived susceptibility” OR “Perceived vulnerability” AND “Multiple Myeloma” OR “Plasma cell myeloma” OR “Plasma cell malignancy” OR “Plasma cell neoplasm” OR “Monoclonal plasma cell disorder” AND Africa OR Algeria OR Angola OR Benin OR Botswana OR “Burkina Faso” OR Burundi OR “Cabo Verde” OR Cameroon OR “Central African Republic” OR Chad OR Comoros OR Congo OR Djibouti OR Egypt OR “Equatorial Guinea” OR Eritrea OR Eswatini OR Ethiopia OR Gabon OR Gambia OR Ghana OR Guinea OR “Ivory Coast” OR “Côte d’Ivoire” OR Kenya OR Lesotho OR Liberia OR Libya OR Madagascar OR Malawi OR Mali OR Mauritania OR Mauritius OR Morocco OR Mozambique OR Namibia OR Niger OR Nigeria OR Rwanda OR “Sao Tome and Principe” OR Senegal OR Seychelles OR “Sierra Leone” OR Somalia OR “South Africa” OR Sudan OR Tanzania OR Togo OR Tunisia OR Uganda OR Zambia OR Zimbabwe	33
Scopus	Advanced query (Awareness OR Knowledge OR “Risk Perception” OR perception OR “Perceived risk” OR “Risk appraisal” OR “Risk assessment” OR “Perceived susceptibility” OR “Perceived vulnerability”) AND TITLE-ABS-KEY (“Multiple Myeloma” OR “Plasma cell myeloma” OR “Plasma cell malignancy” OR “Plasma cell neoplasm” OR “Monoclonal plasma cell disorder”) AND TITLE-ABS-KEY (Africa OR Algeria OR Angola OR Benin OR Botswana OR “Burkina Faso” OR Burundi OR “Cabo Verde” OR Cameroon OR “Central African Republic” OR Chad OR Comoros OR Congo OR Djibouti OR Egypt OR “Equatorial Guinea” OR Eritrea OR Eswatini OR Ethiopia OR Gabon OR Gambia OR Ghana OR Guinea OR “Ivory Coast” OR “Côte d’Ivoire” OR Kenya OR Lesotho OR Liberia OR Libya OR Madagascar OR Malawi OR Mali OR Mauritania OR Mauritius OR Morocco OR Mozambique OR Namibia OR Niger OR Nigeria OR Rwanda OR “Sao Tome and Principe” OR Senegal OR Seychelles OR “Sierra Leone” OR Somalia OR “South Africa” OR Sudan OR Tanzania OR Togo OR Tunisia OR Uganda OR Zambia OR Zimbabwe) AND PUBYEAR >1999 AND PUBYEAR <2027 AND (LIMIT-TO (LANGUAGE, “English”)	39
CINHAL	(XB (Awareness OR Knowledge OR “Risk Perception” OR perception OR “Perceived risk” OR “Risk appraisal” OR “Risk assessment” OR “Perceived susceptibility” OR “Perceived vulnerability”) OR SU (Awareness OR Knowledge OR “Risk Perception” OR perception OR “Perceived risk” OR “Risk appraisal” OR “Risk assessment” OR “Perceived susceptibility” OR “Perceived vulnerability”)) AND (XB (“Multiple Myeloma” OR “Plasma cell myeloma” OR “Plasma cell malignancy” OR “Plasma cell neoplasm” OR “Monoclonal plasma cell disorder”) OR SU (“Multiple Myeloma” OR “Plasma cell myeloma” OR “Plasma cell malignancy” OR “Plasma cell neoplasm” OR “Monoclonal plasma cell disorder”)) AND (XB (Africa OR Algeria OR Angola OR Benin OR Botswana OR “Burkina Faso” OR Burundi OR “Cabo Verde” OR Cameroon OR “Central African Republic” OR Chad OR Comoros OR Congo OR Djibouti OR Egypt OR “Equatorial Guinea” OR Eritrea OR Eswatini OR Ethiopia OR Gabon OR Gambia OR Ghana OR Guinea OR “Ivory Coast” OR “Côte d’Ivoire” OR Kenya OR Lesotho OR Liberia OR Libya OR Madagascar OR Malawi OR Mali OR Mauritania OR Mauritius OR Morocco OR Mozambique OR Namibia OR Niger OR Nigeria OR Rwanda OR “Sao Tome and Principe” OR Senegal OR Seychelles OR “Sierra Leone” OR Somalia OR “South Africa” OR Sudan OR Tanzania OR Togo OR Tunisia OR Uganda OR Zambia OR Zimbabwe) OR SU (Africa OR Algeria OR Angola OR Benin OR Botswana OR “Burkina Faso” OR Burundi OR “Cabo Verde” OR Cameroon OR “Central African Republic” OR Chad OR Comoros OR Congo OR Djibouti OR Egypt OR “Equatorial Guinea” OR Eritrea OR Eswatini OR Ethiopia OR Gabon OR Gambia OR Ghana OR Guinea OR “Ivory Coast” OR “Côte d’Ivoire” OR Kenya OR Lesotho OR Liberia OR Libya OR Madagascar OR Malawi OR Mali OR Mauritania OR Mauritius OR Morocco OR Mozambique OR Namibia OR Niger OR Nigeria OR Rwanda OR “Sao Tome and Principe” OR Senegal OR Seychelles OR “Sierra Leone” OR Somalia OR “South Africa” OR Sudan OR Tanzania OR Togo OR Tunisia OR Uganda OR Zambia OR Zimbabwe))	6
Web of Science	Awareness OR Knowledge OR “Risk Perception” OR perception OR “Perceived risk” OR “Risk appraisal” OR “Risk assessment” OR “Perceived susceptibility” OR “Perceived vulnerability” (Topic) and “Multiple Myeloma” OR “Plasma cell myeloma” OR “Plasma cell malignancy” OR “Plasma cell neoplasm” OR “Monoclonal plasma cell disorder” (Topic) and Africa OR Algeria OR Angola OR Benin OR Botswana OR “Burkina Faso” OR Burundi OR “Cabo Verde” OR Cameroon OR “Central African Republic” OR Chad OR Comoros OR Congo OR Djibouti OR Egypt OR “Equatorial Guinea” OR Eritrea OR Eswatini OR Ethiopia OR Gabon OR Gambia OR Ghana OR Guinea OR “Ivory Coast” OR “Côte d’Ivoire” OR Kenya OR Lesotho OR Liberia OR Libya OR Madagascar OR Malawi OR Mali OR Mauritania OR Mauritius OR Morocco OR Mozambique OR Namibia OR Niger OR Nigeria OR Rwanda OR “Sao Tome and Principe” OR Senegal OR Seychelles OR “Sierra Leone” OR Somalia OR “South Africa” OR Sudan OR Tanzania OR Togo OR Tunisia OR Uganda OR Zambia OR Zimbabwe (Topic)	17
SA-ePublications	(Awareness OR Knowledge OR “Risk Perception” OR perception OR “Perceived risk” OR “Risk appraisal” OR “Risk assessment” OR “Perceived susceptibility” OR “Perceived vulnerability”) AND (“Multiple Myeloma” OR “Plasma cell myeloma” OR “Plasma cell malignancy” OR “Plasma cell neoplasm” OR “Monoclonal plasma cell disorder”)	109

Selection of eligible studies

Inclusion criteria

• Studies presenting evidence or results on knowledge awareness and risk perception of MM in Africa.
• Primary empirical studies, review articles, conference papers and grey literature published from 2000 to current.
• Studies published in English

Exclusion criteria

• Studies of presenting evidence from countries outside Africa
• Articles published before 2000

The literature search was performed by an independent reviewer who uploaded all emerging articles into EndNote X20 software. Four independent reviewers conducted a thorough title screening, and all studies that did not meet the inclusion criteria were excluded, while duplicates were removed. The final EndNote database was shared for abstract and full-text screening. The four reviewers examined abstracts and full texts from all records based on the review question and inclusion and exclusion criteria. Consensus was mediated through a fifth independent reviewer who is one of the authors in this paper. Efforts were made to obtain full-text articles by consulting experts in the field, conducting comprehensive web-based searches, and contacting relevant authors. The retrieved articles were then downloaded, stored on an electronic drive, and charted onto a relevant template. The study selection process is summarized using the PRISMA diagram shown in Figure 1.

Figure 1. Prisma diagram illustrating the article selection process.

Charting the data

A modified data charting template was used to collect relevant information from the articles included in the review. The elements of the data in this template were fields similar to those in previous reviews; its core components are shown in Table 3. The process of data charting ensured the synthesis and interpretation of all studies identified, in accordance with the review’s inclusion and exclusion criteria.

Collating, summarizing and reporting the findings

The review findings are presented narratively using the Population, Concept, and Context (PCC) framework, which aligns the study selection with the main review question (see Table 2). The review summarizes the literature on knowledge, awareness, and risk perception of MM in Africa. The emerging themes from the combined synthesis of findings are then discussed in relation to research findings available in the global context.

Table 2. PCC Framework.

Population	Concept	Context
Healthcare workers and general public	Knowledege, attitudes and risk perception of Multiple Myeloma (MM)	Africa

Results

The search strategy initially yielded 204 hits; however, after removing duplicates, 180 records remained for title and abstract screening. This screening process resulted in a further exclusion of 162 articles as that did not meet the inclusion criteria. The remaining 18 articles were reviewed in full text, and assessing these full texts led to the exclusion of 10 articles as their contents were irrelevant to this review, leaving only 8 articles (n = 8) for the final analysis. The articles included in this review comprised original research (n = 6)^30–35 and reviews (n = 2).^20,36 The findings show a lack of primary empirical studies on the knowledge, awareness and risk perception of MM in Africa. While these studies report on knowledge and awareness of MM, this was not their primary objective. Rather, it appears that these findings are presented based on inferences made using observational data about suspicion index, patient presentation time for treatment and other clinical outcomes that were being examined in these studies.

Out of the eight articles included, two were from South Africa and Kenya, respectively (n = 2),^31–34 one was from Morocco and Nigeria, respectively (n = 1),^30,35 while the remaining studies were reviews that consolidated literature from the African region (n = 2).^20,36 Overall, most studies report low levels of awareness of MM among healthcare workers (n = 5),^{20,30–32,36} while only two studies report acceptable levels of knowledge and awareness of MM among other healthcare workers (n = 2).^33,34 The remaining article reports acceptable levels of knowledge and awareness among patients with hematological conditions (n = 1),³⁵ without specifically alluding to MM. This study was included because of limitations in the number of relevant studies found and the fact that MM fall under the umbrella of hematological malignancies. Table 3 provides a summary of the studies included in this review and provides an overview of research findings in accordance to the PCC framework adopted for the article selection of this review.⁵⁸

Discussion

This scoping review mapped evidence on awareness, knowledge, and risk perception of MM in Africa. After applying the relevant inclusion criteria, the review found few relevant articles that explicitly addressed the review question. Only one empirical study directly addressed the review question and was conducted in South Africa among medical doctors, using a quantitative descriptive cross-sectional design. The findings of this study showed a high level of knowledge and awareness of MM among medical practitioners surveyed. However, there was a significant gap between the high level of awareness of MM and patient referral, highlighting the need for further research and education among other healthcare professionals, such as nurses.³³ While this study provides information that may inform the design of preventive strategies in the selected South African context, its limitations in terms of sample size, research design and study population limit the generalizability of the findings. This thus necessitate further research to be conducted using different methodologies and in diverse settings so that contextually relevant baseline data may be obtained.

Additionally, most studies in this review cited low levels of MM awareness among clinicians despite not explicitly exploring knowledge, awareness and risk perception as a primary objective. This underscores the importance of conducting more research that will adopt diverse methodologies among different contexts and categories of healthcare professionals, so that appropriate preventive strategies may be designed for educating them on MM. Research suggests that health professionals across different disciplines are increasingly recognized as integral to clinical prevention and population health activities.^37–39 Additionally, evidence from studies on other health conditions suggests that inadequate knowledge and incorrect attitudes among healthcare workers can directly influence patient behaviors and professional practices, leading to delayed diagnosis of diseases and poor clinical outcomes.^40–43 In the context of MM, scholars have argued that research on knowledge, attitudes and perception among healthcare workers provide valuable insights that can guide targeted interventions and educational initiatives that ultimately promote the holistic well-being of patients.^26,44 These findings imply that such research in Africa must be conducted among all categories of health workers, with urgent attention to medical doctors, specialist physicians, nurses and community healthcare workers.

The review also reveals a paucity of research among patients and the general population, similar to healthcare workers. This finding is consistent with literature reporting challenges with a low diagnostic suspicion index for MM in African healthcare settings.^20,45,46 Research suggests that this may be attributed to low levels of awareness and knowledge of MM among healthcare practitioners and may be associated with the general paucity of research in Africa.²⁰ Delayed diagnosis can lead to presentation at advanced disease stages and is associated with life-threatening complications and shorter progression-free survival.⁴⁷ In Africa, this is concerning as an increased disease burden may place a greater strain on healthcare resources, as the region is faced with prevailing health challenges such as high rates of HIV/AIDS, Tuberculosis and non-communicable diseases such as hypertension, diabetes, violence and injury. This is further compounded by financial and infrastructure challenges that affect the quality of health service delivery. The disparities in diagnostic capabilities and treatment of MM in resource-limited settings such as Africa, thus require multi-faceted interventions to bridge the gap between evidence-based care, access to treatment and prevention through education.⁴⁸

Empirical evidence on knowledge, awareness, and perspectives regarding health-related conditions is thus crucial for public health efforts focused on prevention and health promotion. For MM, understanding and awareness of the condition is vital for ensuring timely diagnosis, referral, and effective management. This highlights the important role of healthcare workers in recognizing the clinical signs of MM.⁴⁹ Similarly, other studies have reported on the significance of patients’ awareness of their health conditions and the subsequent impact on engagement with treatment and care.⁵⁰ Ailawadhi et al. have also stressed that collecting patient-level data to identify knowledge gaps and developing targeted interventions to address them is essential.⁵¹ Research data on knowledge and awareness of other types of cancers, such as cervical and breast cancer, also demonstrates the importance of such evidence for interventions like health education, screening, and early detection.^52,53 The World Health Organization also advocates adopting health promotion strategies to manage and control the rising burden of non-communicable diseases. Health education is considered a cornerstone of health promotion interventions that empowers individuals to take control of their lives.⁵⁴

A review of the global epidemiology of MM suggests an increasing incidence among men aged 50 years and older, with higher mortality among men.⁵⁵ Furthermore, recent data reveal that while the incidence rates were highest in North America and Australia, the highest mortality rates (1.8/100 000) were found in Australia, Northern Europe, and Southern Africa.⁵⁶ Recent literature reports higher incidence and prevalence rates among black populations.⁵⁷ Since Africa is home to the largest black population globally, urgent comprehensive research is required to understand the precise magnitude of the condition. Moreover, studies to providing baseline evidence on current knowledge, awareness and perceptions of MM are required for developing appropriate health promotion interventions to curb the potential burden of disease in Africa.

Recommendations

Based on study findings and research gaps identified, the following recommendations are proposed to support further research, education and clinical practice related to MM in Africa:

• More research should be conducted in Africa on MM, particularly behavioral studies to elicit knowledge, attitudes, perceptions and awareness of MM among healthcare workers (nurses, medical doctors, community health workers, pharmacists) and the general public. Studies should adopt various research designs, such as quantitative, qualitative, mixed methods and action research approaches to inform and evaluate appropriate interventions for the prevention and treatment of MM based on the contextual realities of the African context.
• Training of healthcare workers on clinical signs and symptoms of the condition and the appropriate management and referral pathways aligned with contextual health service delivery models. Contents of training and clinical management on the signs and symptoms of MM should also be integrated into current routine primary health care systems and health service packages for screening, diagnosis and referral pertaining to acute and chronic ailments.
• Strengthen current routine health surveillance systems to include data indicators for monitoring of incidence, prevalence, suspicion index, referral and treatment of MM at all spheres of the public health system in Africa. Actively track the suspicion index for MM at primary care levels and provide support to clinical staff to enhance diagnostic practices through evidenced based participatory approaches.
• Initiate contextually appropriate community-based education programs founded on human-centred designs adopting implementation science research approaches to test and scale up appropriate interventions.
• Facilitate training of pre-service health professionals on MM by ensuring inclusion of learning content in undergraduate health science curricula focusing on prevention and health promotion aspects.

Limitations

While this review provides foundational information on the current research gaps about knowledge, attitudes and risk perception of MM in Africa, it is not without limitations. These relate to the database selection, which only included five databases with language and time restrictions that might have contributed to the scarcity of studies found, as the publication period was limited to articles published from the year 2000 onwards. The review findings nonetheless provide important, comprehensive information on the current state of research in the African context, highlighting the need for urgent research in this area.

Conclusion

This scoping review aimed to map evidence on awareness, knowledge, and risk perception of MM in Africa. To the researchers’ knowledge, this was the first scoping review conducted in the African context. The review findings indicate several research gaps in Africa. The review revealed a conspicuous dearth of contextual empirical research utilizing various research designs to understand this subject matter. The paucity of research thus poses challenges for the design of effective preventive strategies that may be tailored to various population groups and settings. In Africa, health services are predominantly rendered through a primary healthcare approach, thus requiring evidence-based approaches to health promotion and prevention. Further research on MM, knowledge, awareness and risk perception of MM should thus be conducted among various population groups, including different categories of healthcare workers, policy makers, patients and the general public. This will contribute to comprehensive baseline data that may inform the design of evidence-based interventions to prevent MM and related hematological malignancies in Africa.

Data Availability

No primary data are associated with this article, relevant research papers used are included intext as citations and on the data charting table in the results section, see supplementary file for detail DOI: 10.17605/OSF.IO/UZAN7 .⁵⁸

Data is available under the terms of the CC-By Attribution 4.0 International.

References

1. Giannakoulas N, Ntanasis-Stathopoulos I, Terpos E: The Role of Marrow Microenvironment in the Growth and Development of Malignant Plasma Cells in Multiple Myeloma. Int. J. Mol. Sci. 2021; 22(9): 4462. PubMed Abstract | Publisher Full Text | Free Full Text
2. Alejo E, Puertas B, Mateos M-V: Monoclonal gammopathy of uncertain significance. Medicina Clínica (English Edition). 2023.
3. Michels TC, Petersen KE: Multiple myeloma: diagnosis and treatment. Am. Fam. Physician. 2017; 95(6): 373–383A.
4. Huang J, Chan SC, Lok V, et al.: The epidemiological landscape of multiple myeloma: a global cancer registry estimate of disease burden, risk factors, and temporal trends. The Lancet Haematology. 2022; 9(9): e670–e677. PubMed Abstract | Publisher Full Text
5. Geng J, Zhao J, Fan R, et al.: Global, regional, and national burden and quality of care of multiple myeloma, 1990-2019. J. Glob. Health. 2024; 14: 04033. PubMed Abstract | Publisher Full Text | Free Full Text
6. Zhou L, Yu Q, Wei G, et al.: Measuring the global, regional, and national burden of multiple myeloma from 1990 to 2019. BMC Cancer. 2021; 21(1): 606. PubMed Abstract | Publisher Full Text | Free Full Text
7. Karunarathna I, et al.: Understanding multiple myeloma: Diagnosis, clinical presentation, and management. ResearchGate. 2024; Reference Source
8. Sadaf H, et al.: Multiple myeloma etiology and treatment. J. Transl. Genet. Genom. 2022; 6: 63–83.
9. Rajkumar SV: Multiple myeloma: 2020 update on diagnosis, risk-stratification and management. Am. J. Hematol. 2020; 95(5): 548–567. PubMed Abstract | Publisher Full Text
10. Bird SA, Boyd K: Multiple myeloma: an overview of management. Palliative Care and Social Practice. 2019; 13: 1178224219868235. PubMed Abstract | Publisher Full Text | Free Full Text
11. Koshiaris C: Methods for reducing delays in the diagnosis of multiple myeloma. Taylor & Francis; 2019; IJH13.
12. Ghalehsari N, Zahid S, Main O, et al.: Exploring health disparities in diagnosing multiple myeloma. Expert Rev. Hematol. 2024; 17(10): 749–753. PubMed Abstract | Publisher Full Text
13. Pimentel M, Espinal O, Godinez F, et al.: Consensus Statement: Importance of Timely Access to Multiple Myeloma Diagnosis and Treatment in Central America and the Caribbean. J Hematol. 2022; 11(1): 1–7. PubMed Abstract | Publisher Full Text | Free Full Text
14. Gouda HN, Charlson F, Sorsdahl K, et al.: Burden of non-communicable diseases in sub-Saharan Africa, 1990–2017: results from the Global Burden of Disease Study 2017. Lancet Glob. Health. 2019; 7(10): e1375–e1387. PubMed Abstract | Publisher Full Text
15. Gelaw YA, Williams G, Soares Magalhães RJ, et al.: HIV prevalence among tuberculosis patients in sub-Saharan Africa: a systematic review and meta-analysis. AIDS Behav. 2019; 23: 1561–1575. Publisher Full Text
16. Prager GW, Braga S, Bystricky B, et al.: Global cancer control: responding to the growing burden, rising costs and inequalities in access. ESMO Open. 2018; 3(2): e000285. PubMed Abstract | Publisher Full Text | Free Full Text
17. Gomez M, Perdiguero J, Sanz A: Socioeconomic factors affecting water access in rural areas of low and middle income countries. Water. 2019; 11(2): 202. Publisher Full Text
18. Omam L-A, Jarman E, O’Laughlin KN, et al.: Primary healthcare delivery models in African conflict-affected settings: a systematic review. Confl. Heal. 2023; 17(1): 34. PubMed Abstract | Publisher Full Text | Free Full Text
19. Organization, W.H: Continuity and coordination of care: a practice brief to support implementation of the WHO Framework on integrated people-centred health services.2018.
20. Thokerunga E, Ntege C, Ahmed AO: Are African primary physicians suspicious enough? Challenges of multiple myeloma diagnosis in Africa. The Egyptian Journal of Internal Medicine. 2021; 33(1): 54. Publisher Full Text
21. Mattar M, Bazarbachi A, Abduljalil O, et al.: Epidemiology, treatment trends, and outcomes of multiple myeloma in the Middle East and Africa: a systematic review. Clinical Hematology International. 2024; 6(1): 67–83. PubMed Abstract | Publisher Full Text
22. Ojo IS, Badero OJ, Oluwalana TO, et al.: Epidemiology of Monoclonal Gammopathies in Sub-Saharan Africa: A Systematic Review and Meta-Analysis of MGUS and Multiple Myeloma. Trop. Med. Int. Health. 2026; 31: 237–253. PubMed Abstract | Publisher Full Text | Free Full Text
23. Chili LH, Mackraj I, Rapiti N: Profile and outcome of multiple myeloma with and without HIV treated at a tertiary hospital in KwaZulu-Natal, South Africa. PLoS One. 2023; 18(10): e0287304. PubMed Abstract | Publisher Full Text | Free Full Text
24. Acquah ME, Hsing AW, McGuire V, et al.: Presentation and survival of multiple myeloma patients in Ghana: a review of 169 cases. Ghana Med. J. 2019; 53(1): 52–58. PubMed Abstract | Publisher Full Text | Free Full Text
25. Hunter R, Jenkins V, Fallowfield L, et al.: Patient and caregiver understanding of multiple myeloma: A scoping review. Eur. J. Oncol. Nurs. 2025; 79: 102992. PubMed Abstract | Publisher Full Text
26. Zou L, Li J, Xiang H, et al.: Knowledge, attitude and practice towards multiple myeloma among medical staff in Enshi Region. Sci. Rep. 2025; 15(1): 3406. PubMed Abstract | Publisher Full Text | Free Full Text
27. Nwabuko OC, Igbigbi E, Ejele OA: Promoting public health campaign on awareness and screening for multiple myeloma in Nigeria. Arch Hematol Blood Dis. 2018; 1(2): 15–20. Publisher Full Text
28. Nwabuko OC, John RE: Assessment of the Effectiveness of Health Education and Screening Test in Reducing Multiple Myeloma in the Middle-Elderly Nigerians–A Study Proposal Methodology. British Journal of Healthcare and Medical Research-Vol. 2022; 9(2).
29. Arksey H, O'Malley L: Scoping studies: towards a methodological framework. Int. J. Soc. Res. Methodol. 2005; 8(1): 19–32. Publisher Full Text
30. Collins NO, et al.: Plasma Cell Myeloma: Challenges in Diagnosis in Sub-Saharan Africa.
31. De Groot J, et al.: Concomitant HIV infection in newly diagnosed multiple myeloma patients is hard to recognise and should be tested for routinely in areas of high endemicity. S. Afr. Med. J. 2017; 107(9): 781–787. Publisher Full Text
32. Oduor MA, Lotodo TC, Vik TA, et al.: Building a sustainable comprehensive multiple myeloma program in western Kenya. JCO Glob Oncol. 2021; 7(1): 400–407. Publisher Full Text
33. Pooe AM, Dlova AN, Ntuli ST: Medical practitioners’ knowledge and awareness of multiple myeloma at public hospitals, Gauteng, South Africa. S. Afr. Fam. Pract. 2023; 65(3): e1–e6. PubMed Abstract | Publisher Full Text | Free Full Text
34. Oduor MA, Lotodo TC, Severance T, et al.: Expanding Myeloma Training and Care in Western Kenya Through the ECHO Model: The Pilot Phase. JCO Global Oncology. 2024; 10: e2300416. Publisher Full Text
35. El Habchi M, et al.: Assessment of Educational Needs of Patients in Clinical Hematology Towards the Implementation of a Structured Therapeutic Education Program. Open Public Health J. 2024; 17(1).
36. Bolarinwa A, Odukoya L, Buadi F, et al.: Monoclonal Gammopathies in Africa. Clin. Lymphoma Myeloma Leuk. 2025; 25: e696–e703.e2. PubMed Abstract | Publisher Full Text | Free Full Text
37. Zenzano T, Allan JD, Bigley MB, et al.: The Roles of Healthcare Professionals in Implementing Clinical Prevention and Population Health. Am. J. Prev. Med. 2011; 40(2): 261–267. Publisher Full Text
38. Lundin Gurne F, Jakobsson S, Lidén E, et al.: District nurses' perspectives on health-promotive and disease-preventive work at primary health care centres: A qualitative study. Scand. J. Caring Sci. 2023; 37(1): 153–162. Publisher Full Text
39. Almarzouq YF, Al Salim HA: The role of physicians in promoting preventive healthcare. Int. J. Health Sci. 2024; 8(S1): 1949–1964.
40. Abdel Wahed WY, Hefzy EM, Ahmed MI, et al.: Assessment of knowledge, attitudes, and perception of health care workers regarding COVID-19, a cross-sectional study from Egypt. J. Community Health. 2020; 45(6): 1242–1251. PubMed Abstract | Publisher Full Text | Free Full Text
41. Abebe TB, Bhagavathula AS, Tefera YG, et al.: Healthcare professionals’ awareness, knowledge, attitudes, perceptions and beliefs about Ebola at Gondar University Hospital, Northwest Ethiopia: a cross-sectional study. Journal of Public Health in Africa. 2016; 7(2): 570. PubMed Abstract | Publisher Full Text
42. Yenit MK, Kolbe-Alexander TL, Gelaye KA, et al.: An evaluation of community health workers’ knowledge, attitude and personal lifestyle behaviour in non-communicable disease health promotion and their association with self-efficacy and NCD-risk perception. Int. J. Environ. Res. Public Health. 2023; 20(9): 5642. PubMed Abstract | Publisher Full Text | Free Full Text
43. Maimela E, van Geertruyden JP, Alberts M, et al.: The perceptions and perspectives of patients and health care providers on chronic diseases management in rural South Africa: a qualitative study. BMC Health Serv. Res. 2015; 15(1): 143. PubMed Abstract | Publisher Full Text | Free Full Text
44. Murray S, Mohty M, Peloquin S, et al.: Identifying educational needs and practice gaps of European hematologists and hematology nurses in the treatment and management of multiple myeloma. HemaSphere. 2018; 2(2): e33. PubMed Abstract | Publisher Full Text | Free Full Text
45. Obu SI, Dibigbo–Ibeaji N, Obu GO, et al.: Diagnostic Challenges in Hematological Malignancies in Nigeria and their Impact on Treatment Outcome. International Blood Research & Reviews. 2024; 15(4): 8–15. Publisher Full Text
46. Coly MN, Guèye MW, Makalou D, et al.: Diagnostic and Prognostic Challenges in Cytology for Multiple Myeloma: A Case Series in a Resource-limited Setting. Journal of Clinical Haematology. 2025; 6(1): 1–6. Publisher Full Text
47. Zorlu T, Kayer MA, Okumus N, et al.: Challenges, Difficulties, and Delayed Diagnosis of Multiple Myeloma. Diagnostics. 2025; 15(13): 1708. PubMed Abstract | Publisher Full Text | Free Full Text
48. Tiwari B, Sapkota S: Optimising multiple myeloma therapy in resource-limited settings: current perspectives and challenges. Ecancermedicalscience. 2025; 19: 2005. Publisher Full Text
49. Kariyawasan CC, Hughes DA, Jayatillake MM, et al.: Multiple myeloma: causes and consequences of delay in diagnosis. QJM: An International Journal of Medicine. 2007; 100(10): 635–640. PubMed Abstract | Publisher Full Text
50. Ailawadhi S, Swaika A, Advani P, et al.: Current State of Patient Awareness and Participation in Care for Multiple Myeloma and the Psychophysical Impact of Treatment: An International Internet-Based Study. Blood. 2014; 124(21): 1294–1294. Publisher Full Text
51. Ailawadhi S, Swaika A, Advani P, et al.: Awareness of myeloma care and the global impact of treatment: An international internet-based prospective study. J. Oncol. Pharm. Pract. 2021; 28(2): 425–433. Publisher Full Text
52. Rademaker C, Bhandary S, Harder H: Knowledge, awareness, attitudes and screening practices towards breast and cervical cancer among women in Nepal: a scoping review. J. Public Health. 2022; 30(8): 1995–2027. Publisher Full Text
53. Tiiti TA, Bogers J, Lebelo RL: Knowledge of human papillomavirus and cervical cancer among women attending gynecology clinics in Pretoria, South Africa. Int. J. Environ. Res. Public Health. 2022; 19(7): 4210. PubMed Abstract | Publisher Full Text | Free Full Text
54. Hou S-I: Health education: theoretical concepts, effective strategies and core competencies. Health Promot. Pract. 2014; 15(5): 619–621.
55. Huang J, Chan SC, Lok V, et al.: The epidemiological landscape of multiple myeloma: a global cancer registry estimate of disease burden, risk factors, and temporal trends. The Lancet Haematology. 2022; 9(9): e670–e677. PubMed Abstract | Publisher Full Text
56. Mafra A, Laversanne M, Marcos-Gragera R, et al.: The global multiple myeloma incidence and mortality burden in 2022 and predictions for 2045. JNCI J. Natl. Cancer Inst. 2024; 117(5): 907–914. Publisher Full Text
57. Ojo IS, Badero OJ, Oluwalana TO, et al.: Epidemiology of Monoclonal Gammopathies in Sub-Saharan Africa: A Systematic Review and Meta-Analysis of MGUS and Multiple Myeloma. Trop. Med. Int. Health. 2026; 31(3): 237–253. PubMed Abstract | Publisher Full Text | Free Full Text
58. Nxumalo CT, Chiya, Ramotshela S, et al.: [Dataset]. Publisher Full Text

Comments on this article Comments (0)

Version 1

VERSION 1 PUBLISHED 08 Jun 2026

Author details Author details

¹ Research Development and Postgraduate Support, Office of the DVC Research and Innovation, University of the Western Cape, Bellville, Western Cape, South Africa
² Discipline of Nursing, University of KwaZulu-Natal School of Nursing and Public Health, Durban, KwaZulu-Natal, South Africa
³ AFIA TIA, Non-Profit Organisation, Durban, KwaZulu-Natal, South Africa
⁴ Centre for Rural Health, University of KwaZulu-Natal School of Nursing and Public Health, Durban, KwaZulu-Natal, South Africa

Celenkosini Thembelenkosini Nxumalo
Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Validation, Writing – Original Draft Preparation, Writing – Review & Editing

Hlolisile Chiya
Roles: Resources, Validation, Writing – Original Draft Preparation, Writing – Review & Editing

Sibongile Ramotshela
Roles: Funding Acquisition, Investigation, Validation, Writing – Review & Editing

Usangiphile Buthelezi
Roles: Formal Analysis, Project Administration, Validation, Writing – Review & Editing

Zamasomi Luvuno
Roles: Conceptualization, Funding Acquisition, Investigation, Resources, Validation, Writing – Review & Editing

Competing interests

No competing interests were disclosed.

Grant information

The research reported in this article was funded by the Bristol Myers Squibb Foundation. The content is solely the responsibility of the authors and does not necessarily represent the official views of funder or affiliation of the authors.
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Article Versions (1)

version 1

Published: 08 Jun 2026, 15:889

https://doi.org/10.12688/f1000research.178123.1

Copyright

© 2026 Thembelenkosini Nxumalo C et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Download

Export To

metrics

	Views	Downloads
F1000Research	-	-
PubMed Central Data from PMC are received and updated monthly.	-	-

Citations

0

SEE MORE DETAILS

CITE

how to cite this article

Thembelenkosini Nxumalo C, Chiya H, Ramotshela S et al. Mapping evidence on Awareness, Knowledge and Risk Perception of Multiple Myeloma (MM) in Africa: A Scoping Review [version 1; peer review: awaiting peer review]. F1000Research 2026, 15:889 (https://doi.org/10.12688/f1000research.178123.1)

NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article.

track

receive updates on this article

Track an article to receive email alerts on any updates to this article.

Open Peer Review

Comments on this article Comments (0)

Version 1

VERSION 1 PUBLISHED 08 Jun 2026

Open Peer Review

Reviewer Status

AWAITING PEER REVIEW

Comments on this article

All Comments(0)

Add a comment

Sign up for content alerts

Browse by related subjects

[1] 1. Giannakoulas N, Ntanasis-Stathopoulos I, Terpos E: The Role of Marrow Microenvironment in the Growth and Development of Malignant Plasma Cells in Multiple Myeloma. Int. J. Mol. Sci. 2021; 22(9): 4462. PubMed Abstract | Publisher Full Text | Free Full Text

[2] 2. Alejo E, Puertas B, Mateos M-V: Monoclonal gammopathy of uncertain significance. Medicina Clínica (English Edition). 2023.

[3] 3. Michels TC, Petersen KE: Multiple myeloma: diagnosis and treatment. Am. Fam. Physician. 2017; 95(6): 373–383A.

[4] 4. Huang J, Chan SC, Lok V, et al.: The epidemiological landscape of multiple myeloma: a global cancer registry estimate of disease burden, risk factors, and temporal trends. The Lancet Haematology. 2022; 9(9): e670–e677. PubMed Abstract | Publisher Full Text

[5] 5. Geng J, Zhao J, Fan R, et al.: Global, regional, and national burden and quality of care of multiple myeloma, 1990-2019. J. Glob. Health. 2024; 14: 04033. PubMed Abstract | Publisher Full Text | Free Full Text

[6] 6. Zhou L, Yu Q, Wei G, et al.: Measuring the global, regional, and national burden of multiple myeloma from 1990 to 2019. BMC Cancer. 2021; 21(1): 606. PubMed Abstract | Publisher Full Text | Free Full Text

[7] 7. Karunarathna I, et al.: Understanding multiple myeloma: Diagnosis, clinical presentation, and management. ResearchGate. 2024; Reference Source

[8] 8. Sadaf H, et al.: Multiple myeloma etiology and treatment. J. Transl. Genet. Genom. 2022; 6: 63–83.

[9] 9. Rajkumar SV: Multiple myeloma: 2020 update on diagnosis, risk-stratification and management. Am. J. Hematol. 2020; 95(5): 548–567. PubMed Abstract | Publisher Full Text

[10] 10. Bird SA, Boyd K: Multiple myeloma: an overview of management. Palliative Care and Social Practice. 2019; 13: 1178224219868235. PubMed Abstract | Publisher Full Text | Free Full Text

[11] 11. Koshiaris C: Methods for reducing delays in the diagnosis of multiple myeloma. Taylor & Francis; 2019; IJH13.

[12] 12. Ghalehsari N, Zahid S, Main O, et al.: Exploring health disparities in diagnosing multiple myeloma. Expert Rev. Hematol. 2024; 17(10): 749–753. PubMed Abstract | Publisher Full Text

[13] 13. Pimentel M, Espinal O, Godinez F, et al.: Consensus Statement: Importance of Timely Access to Multiple Myeloma Diagnosis and Treatment in Central America and the Caribbean. J Hematol. 2022; 11(1): 1–7. PubMed Abstract | Publisher Full Text | Free Full Text

[14] 14. Gouda HN, Charlson F, Sorsdahl K, et al.: Burden of non-communicable diseases in sub-Saharan Africa, 1990–2017: results from the Global Burden of Disease Study 2017. Lancet Glob. Health. 2019; 7(10): e1375–e1387. PubMed Abstract | Publisher Full Text

[15] 15. Gelaw YA, Williams G, Soares Magalhães RJ, et al.: HIV prevalence among tuberculosis patients in sub-Saharan Africa: a systematic review and meta-analysis. AIDS Behav. 2019; 23: 1561–1575. Publisher Full Text

[16] 16. Prager GW, Braga S, Bystricky B, et al.: Global cancer control: responding to the growing burden, rising costs and inequalities in access. ESMO Open. 2018; 3(2): e000285. PubMed Abstract | Publisher Full Text | Free Full Text

[17] 17. Gomez M, Perdiguero J, Sanz A: Socioeconomic factors affecting water access in rural areas of low and middle income countries. Water. 2019; 11(2): 202. Publisher Full Text

[18] 18. Omam L-A, Jarman E, O’Laughlin KN, et al.: Primary healthcare delivery models in African conflict-affected settings: a systematic review. Confl. Heal. 2023; 17(1): 34. PubMed Abstract | Publisher Full Text | Free Full Text

[19] 19. Organization, W.H: Continuity and coordination of care: a practice brief to support implementation of the WHO Framework on integrated people-centred health services.2018.

[20] 20. Thokerunga E, Ntege C, Ahmed AO: Are African primary physicians suspicious enough? Challenges of multiple myeloma diagnosis in Africa. The Egyptian Journal of Internal Medicine. 2021; 33(1): 54. Publisher Full Text

[21] 21. Mattar M, Bazarbachi A, Abduljalil O, et al.: Epidemiology, treatment trends, and outcomes of multiple myeloma in the Middle East and Africa: a systematic review. Clinical Hematology International. 2024; 6(1): 67–83. PubMed Abstract | Publisher Full Text

[22] 22. Ojo IS, Badero OJ, Oluwalana TO, et al.: Epidemiology of Monoclonal Gammopathies in Sub-Saharan Africa: A Systematic Review and Meta-Analysis of MGUS and Multiple Myeloma. Trop. Med. Int. Health. 2026; 31: 237–253. PubMed Abstract | Publisher Full Text | Free Full Text

[23] 23. Chili LH, Mackraj I, Rapiti N: Profile and outcome of multiple myeloma with and without HIV treated at a tertiary hospital in KwaZulu-Natal, South Africa. PLoS One. 2023; 18(10): e0287304. PubMed Abstract | Publisher Full Text | Free Full Text

[24] 24. Acquah ME, Hsing AW, McGuire V, et al.: Presentation and survival of multiple myeloma patients in Ghana: a review of 169 cases. Ghana Med. J. 2019; 53(1): 52–58. PubMed Abstract | Publisher Full Text | Free Full Text

[25] 25. Hunter R, Jenkins V, Fallowfield L, et al.: Patient and caregiver understanding of multiple myeloma: A scoping review. Eur. J. Oncol. Nurs. 2025; 79: 102992. PubMed Abstract | Publisher Full Text

[26] 26. Zou L, Li J, Xiang H, et al.: Knowledge, attitude and practice towards multiple myeloma among medical staff in Enshi Region. Sci. Rep. 2025; 15(1): 3406. PubMed Abstract | Publisher Full Text | Free Full Text

[27] 27. Nwabuko OC, Igbigbi E, Ejele OA: Promoting public health campaign on awareness and screening for multiple myeloma in Nigeria. Arch Hematol Blood Dis. 2018; 1(2): 15–20. Publisher Full Text

[28] 28. Nwabuko OC, John RE: Assessment of the Effectiveness of Health Education and Screening Test in Reducing Multiple Myeloma in the Middle-Elderly Nigerians–A Study Proposal Methodology. British Journal of Healthcare and Medical Research-Vol. 2022; 9(2).

[29] 29. Arksey H, O'Malley L: Scoping studies: towards a methodological framework. Int. J. Soc. Res. Methodol. 2005; 8(1): 19–32. Publisher Full Text

[30] 30. Collins NO, et al.: Plasma Cell Myeloma: Challenges in Diagnosis in Sub-Saharan Africa.

[31] 31. De Groot J, et al.: Concomitant HIV infection in newly diagnosed multiple myeloma patients is hard to recognise and should be tested for routinely in areas of high endemicity. S. Afr. Med. J. 2017; 107(9): 781–787. Publisher Full Text

[32] 32. Oduor MA, Lotodo TC, Vik TA, et al.: Building a sustainable comprehensive multiple myeloma program in western Kenya. JCO Glob Oncol. 2021; 7(1): 400–407. Publisher Full Text

[33] 33. Pooe AM, Dlova AN, Ntuli ST: Medical practitioners’ knowledge and awareness of multiple myeloma at public hospitals, Gauteng, South Africa. S. Afr. Fam. Pract. 2023; 65(3): e1–e6. PubMed Abstract | Publisher Full Text | Free Full Text

[34] 34. Oduor MA, Lotodo TC, Severance T, et al.: Expanding Myeloma Training and Care in Western Kenya Through the ECHO Model: The Pilot Phase. JCO Global Oncology. 2024; 10: e2300416. Publisher Full Text

[35] 35. El Habchi M, et al.: Assessment of Educational Needs of Patients in Clinical Hematology Towards the Implementation of a Structured Therapeutic Education Program. Open Public Health J. 2024; 17(1).

[36] 36. Bolarinwa A, Odukoya L, Buadi F, et al.: Monoclonal Gammopathies in Africa. Clin. Lymphoma Myeloma Leuk. 2025; 25: e696–e703.e2. PubMed Abstract | Publisher Full Text | Free Full Text

[37] 37. Zenzano T, Allan JD, Bigley MB, et al.: The Roles of Healthcare Professionals in Implementing Clinical Prevention and Population Health. Am. J. Prev. Med. 2011; 40(2): 261–267. Publisher Full Text

[38] 38. Lundin Gurne F, Jakobsson S, Lidén E, et al.: District nurses' perspectives on health-promotive and disease-preventive work at primary health care centres: A qualitative study. Scand. J. Caring Sci. 2023; 37(1): 153–162. Publisher Full Text

[39] 39. Almarzouq YF, Al Salim HA: The role of physicians in promoting preventive healthcare. Int. J. Health Sci. 2024; 8(S1): 1949–1964.

[40] 40. Abdel Wahed WY, Hefzy EM, Ahmed MI, et al.: Assessment of knowledge, attitudes, and perception of health care workers regarding COVID-19, a cross-sectional study from Egypt. J. Community Health. 2020; 45(6): 1242–1251. PubMed Abstract | Publisher Full Text | Free Full Text

[41] 41. Abebe TB, Bhagavathula AS, Tefera YG, et al.: Healthcare professionals’ awareness, knowledge, attitudes, perceptions and beliefs about Ebola at Gondar University Hospital, Northwest Ethiopia: a cross-sectional study. Journal of Public Health in Africa. 2016; 7(2): 570. PubMed Abstract | Publisher Full Text

[42] 42. Yenit MK, Kolbe-Alexander TL, Gelaye KA, et al.: An evaluation of community health workers’ knowledge, attitude and personal lifestyle behaviour in non-communicable disease health promotion and their association with self-efficacy and NCD-risk perception. Int. J. Environ. Res. Public Health. 2023; 20(9): 5642. PubMed Abstract | Publisher Full Text | Free Full Text

[43] 43. Maimela E, van Geertruyden JP, Alberts M, et al.: The perceptions and perspectives of patients and health care providers on chronic diseases management in rural South Africa: a qualitative study. BMC Health Serv. Res. 2015; 15(1): 143. PubMed Abstract | Publisher Full Text | Free Full Text

[44] 44. Murray S, Mohty M, Peloquin S, et al.: Identifying educational needs and practice gaps of European hematologists and hematology nurses in the treatment and management of multiple myeloma. HemaSphere. 2018; 2(2): e33. PubMed Abstract | Publisher Full Text | Free Full Text

[45] 45. Obu SI, Dibigbo–Ibeaji N, Obu GO, et al.: Diagnostic Challenges in Hematological Malignancies in Nigeria and their Impact on Treatment Outcome. International Blood Research & Reviews. 2024; 15(4): 8–15. Publisher Full Text

[46] 46. Coly MN, Guèye MW, Makalou D, et al.: Diagnostic and Prognostic Challenges in Cytology for Multiple Myeloma: A Case Series in a Resource-limited Setting. Journal of Clinical Haematology. 2025; 6(1): 1–6. Publisher Full Text

[47] 47. Zorlu T, Kayer MA, Okumus N, et al.: Challenges, Difficulties, and Delayed Diagnosis of Multiple Myeloma. Diagnostics. 2025; 15(13): 1708. PubMed Abstract | Publisher Full Text | Free Full Text

[48] 48. Tiwari B, Sapkota S: Optimising multiple myeloma therapy in resource-limited settings: current perspectives and challenges. Ecancermedicalscience. 2025; 19: 2005. Publisher Full Text

[49] 49. Kariyawasan CC, Hughes DA, Jayatillake MM, et al.: Multiple myeloma: causes and consequences of delay in diagnosis. QJM: An International Journal of Medicine. 2007; 100(10): 635–640. PubMed Abstract | Publisher Full Text

[50] 50. Ailawadhi S, Swaika A, Advani P, et al.: Current State of Patient Awareness and Participation in Care for Multiple Myeloma and the Psychophysical Impact of Treatment: An International Internet-Based Study. Blood. 2014; 124(21): 1294–1294. Publisher Full Text

[51] 51. Ailawadhi S, Swaika A, Advani P, et al.: Awareness of myeloma care and the global impact of treatment: An international internet-based prospective study. J. Oncol. Pharm. Pract. 2021; 28(2): 425–433. Publisher Full Text

[52] 52. Rademaker C, Bhandary S, Harder H: Knowledge, awareness, attitudes and screening practices towards breast and cervical cancer among women in Nepal: a scoping review. J. Public Health. 2022; 30(8): 1995–2027. Publisher Full Text

[53] 53. Tiiti TA, Bogers J, Lebelo RL: Knowledge of human papillomavirus and cervical cancer among women attending gynecology clinics in Pretoria, South Africa. Int. J. Environ. Res. Public Health. 2022; 19(7): 4210. PubMed Abstract | Publisher Full Text | Free Full Text

[54] 54. Hou S-I: Health education: theoretical concepts, effective strategies and core competencies. Health Promot. Pract. 2014; 15(5): 619–621.

[55] 55. Huang J, Chan SC, Lok V, et al.: The epidemiological landscape of multiple myeloma: a global cancer registry estimate of disease burden, risk factors, and temporal trends. The Lancet Haematology. 2022; 9(9): e670–e677. PubMed Abstract | Publisher Full Text

[56] 56. Mafra A, Laversanne M, Marcos-Gragera R, et al.: The global multiple myeloma incidence and mortality burden in 2022 and predictions for 2045. JNCI J. Natl. Cancer Inst. 2024; 117(5): 907–914. Publisher Full Text

[57] 57. Ojo IS, Badero OJ, Oluwalana TO, et al.: Epidemiology of Monoclonal Gammopathies in Sub-Saharan Africa: A Systematic Review and Meta-Analysis of MGUS and Multiple Myeloma. Trop. Med. Int. Health. 2026; 31(3): 237–253. PubMed Abstract | Publisher Full Text | Free Full Text

[58] 58. Nxumalo CT, Chiya, Ramotshela S, et al.: [Dataset]. Publisher Full Text

Mapping evidence on Awareness, Knowledge and Risk Perception of Multiple Myeloma (MM) in Africa: A Scoping Review

Abstract

Background

Aim

Methods

Results

Conclusion

Keywords

Background

Methods

Identification of the review question

Identification of the relevant studies

Table 1. Search strategy.

Selection of eligible studies

Figure 1. Prisma diagram illustrating the article selection process.

Charting the data

Collating, summarizing and reporting the findings

Table 2. PCC Framework.

Results

Discussion

Recommendations

Limitations

Conclusion

Data Availability

References

Comments on this article Comments (0)

Open Peer Review

Comments on this article Comments (0)

Open Peer Review

Reviewer Status

Comments on this article

Browse by related subjects

Competing Interests Policy

Stay Updated