Neurological disorders in rural Africa - a systematic approach

Leishmaniasis in Northern and Western Africa: A Review Albert Kimutai 11.9999 Normal 0 false false false MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0pt 5.4pt 0pt 5.4pt; mso-para-margin:0pt; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Background/Objectives Empirical knowledge suggests that neurological disorders are common in sub-Saharan Africa. However, to date prevalence studies are scarce. The aims of our study were to assess the hospital-based prevalence of neurological disorders in a rural African setting and to describe the pattern of disease by using a systematic approach. Methods The study was conducted at the Haydom Lutheran Hospital in northern Tanzania, Manyara region. Over a period of eight months all patients admitted to hospital were seen prospectively in consecutive order by a neurologist (ASW). Results Out of 8676 admissions 740 patients (8.5%) were given a neurological diagnosis. The most frequent neurological disorders were seizures (26.6%) and infectious diseases (18.1%). The overall mortality of neurological disease was 21%. Cases were grouped according to diagnostic certainty. We suggest three major categories for neurological disorders (group 1 = no diagnostic uncertainties; group 2 = minor diagnostic uncertainties; group 3 = major diagnostic uncertainties) with implications regarding therapy and prognosis. Conclusions The above data emphasizes that neurological disease contributes substantially to morbidity and mortality in a rural African hospital. Based on the observed pattern of neurological disorders we suggest a systematic approach