Neurological disorders in rural Africa - a systematic approach

Abstract

Leishmaniasis in Northern and Western Africa: A Review 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 aneurologist (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