Africa: MRI Impact On Youth Football in Africa Explained By CAF Medical Manager Dr Sidiki

With all eyes set on the ongoing TotalEnergies CAF U-17 Africa Cup of Nations, CAFOnline took some time to have an exclusive sit-down with CAF Medical Manager, Dr Sidiki Boubakary on CAF's use of MRI and how it has helped curb the age-old issue of perceived age cheating in African youth football.

CAFOnline: Please explain how MRI technology helps to test age eligibility in boys? Good day, thank you for your important first question. First, CAF MRI Protocol is for eligibilities in U17 boys and not for verification of the age of the players.

This protocol is used since several years, prior to each CAF U17 Qualifiers or Final Tournament. An MRI of the left wrist is performed, under the supervision of a CAF MRI Expert.

The images are sent to the CAF MRI Reading Panel which is the only entity mandated by CAF Medical Committee to read and give the eligibilities.

The role of the CAF MRI Expert is to make sure that the images he is sending to CAF are really belonging to the Players who enter the machine. So, he takes the picture the face of each Player beside his passport, before entering the MRI device of 1.5 tesla.

CAF MRI protocol is putting emphasis on the cartilage of the distal extremity of the radius. If it is completely fused, the Player is not eligible to participate in a CAF U17 Competition.

Why can it not be used for girls? The CAF MRI Protocol is not applicable for Girls U17 because their cartilage is fused earlier, before the age of seventeen (17).

CAF tested every player that will be competing at the TotalEnergies CAF U17 AFCON. Talk us through this process? As said earlier, every single Player participating in the current TotalEnergies CAF U-17 Africa Cup of Nations (AFCON) Morocco 2025, has been tested.

Before entering the MRI 1.5 tesla magnet and a wrist coil, the CAF MRI Expert took a picture his face beside the passport. In five (5) to ten (10) minutes, the left wrist is positioned either above the head or at the side of the body, the third metacarpal is placed as close as possible to the same axis as the radius, only one sequence T1-weighted spin echo is performed.

Images are received on CD and email through WeTransfer, no need for medical report from radiologist, the images are sent to the CAF MRI Reading Committee to read and give the eligibilities to the CAF Medical Department. Then, CAF Tournaments and Events Division is informed, and the respective teams as well.

How many players must be deemed ineligible for a team to be disqualified? A per the CAF Executive Committee Decision dated 11th of April 2023, CAF U17 Rules and Regulations have been updated in its Article 27:

ARTICLE 27

27.1 For the qualifying phase, an eligibility test will be compulsory performed for all the participating teams before the start of the matches.

27.2 The test will be performed according to CAF Protocol in a health facility duly accredited centre where there is an MRI apparatus (Magnetic Resonance Imaging).

27.3 CAF reserve the right to make the eligibility test (MRI) as well during the final phase for the sixteen teams qualified to the tournament. The cost of the MRI test that will be covered by CAF.

27. 4 If after performing the eligibility test (MRI) for a participating team and four (4) or more of its players are found ineligible, the participating team will be disqualified.

27.5. If after performing an MRI test for a participating team and one (1), two (2) or three (3) of its players are found ineligible, the said player(s) will not be allowed to participate in the competition. The concerned team will be allowed to participate in the competition but is not authorized to replace the ineligible player(s).

Have we seen a reduction in the number of players who have been deemed ineligible over the years? Yes, as per the statistics, we move from 7% (2018 / 2019 Edition) of ineligibility to below 1% (2022 / 2023 Edition).

What were the peculiar challenges with dealing with this issue in the past?The peculiar changes are now, we never see overage Players playing in U17 category. Now, we are having a truly U17 boys playing among them. And we don't have protest on age cheating prior to the current TotalEnergies CAF U-17 Africa Cup of Nations Morocco 2025.

How much of work has gone into this for as to have this robust system that everyone is appreciating the talent they are witnessing at this level in Morocco?The CAF Medical Committee worked hard in advance and gave advice to Member Associations on the following aspects, through a Medical and Anti-doping letter sent by CAF Medical Unit:

THE ELIGIBILITY CONDITIONS ARE AS FOLLOWS:· The civil age of less than 17 years on the passport (limit age communicated by CAF).

· The CAF classification on Eligibility for U17 through MRI from grade I to V, grade VI is ineligible.

· The PCCA (Pre-Competition Cardiac Assessment) any player declared unfit is ineligible.

MRI TO BE DONE AT (4) LEVELS:· National: During MRI by respective Associations, CAF is highly encouraging them to request a CAF Expert under Member Association (MA) cost to supervise the MRI according to CAF Protocol. CAF Reading Committee will be available to read the images and provide them with the different grades according to CAF Classification of Eligibilities in U17.

· Prior to Zonal Qualifiers in the host country: CAF organizes and supervises MRI for all the Players participating in the tournament, under CAF cost.

· Prior to the Final Tournament: in case a Federation engages new Players, CAF is highly encouraging him to request a CAF Expert under MA cost to supervise the MRI done in its chosen place, according to CAF Protocol. CAF Reading Committee will be available to read the images and provide him with the eligibilities (CAF Classification for Eligibility in U17).

· In the host country prior to the Final Tournament: CAF organizes and supervises MRI to all the Players participating in the tournament, under CAF cost.

Where do we go from here; what more measures are you going to take to ensure an even more flawless process?In Africa, we have our own realities that are different from those of some confederations such as UEFA, for example. To give these young boys the chance to compete with players in the same category as them, we must continue with this MRI protocol. And even provide a protocol for the upstream and downstream categories (U15 and U20) to achieve traceability leading to young and competitive players in senior categories.

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