Prevalence and incidence of neurological disorders among adult Ugandans in rural and urban Mukono district; a cross-sectional study.

Mark Kaddumukasa,Edward Ddumba,Elly Katabira,Martha Sajatovic,Martin N Kaddumukasa,Leviticus Mugenyi,Anthony Furlan,Michael Devereaux

doi:10.1186/s12883-016-0732-y

Abstract

BackgroundThe burden of neurological diseases is increasing in developing countries. However, there is a prominent scarcity of literature on the incidence of neurological diseases in sub-Saharan Africa. This study was therefore undertaken to determine the prevalence and incidence of neurological diseases in this setting to serve as a baseline for planning and care for neurological disorders in Uganda.MethodsThe study was conducted within rural and urban Mukono district, east of Kampala city of Uganda, central region. Over a period of six months, a cross sectional survey was conducted and screening was performed using a standardized questionnaire. All subjects with neurological symptoms and signs were reviewed by a team of neurologists and neurological diagnoses made.ResultsOf the 3000 study subjects, 50.3% (1510/3000) were from the rural setting. Out of the participants screened, 67.4% were female, with a median age of 33 years. Among the 98 subjects with confirmed neurological disorders, the frequency of diseases was as follows; peripheral neuropathy (46.2%), chronic headaches (26.4%), and epilepsy (8.5%), followed by pain syndromes (7.5%), stroke (6.6%) and tremors/Parkinson disease (3.8%). The crude prevalence rates of these disorders (95% CI) were 14.3% (8.5–24.1); 13.3% (7.7–22.8); 33.7% (23.9–47.4) for stroke, epilepsy and peripheral neuropathy respectively. Peripheral neuropathy followed by chronic headaches had the highest estimated incidence/1000 years. Stroke had an estimated incidence of 3.6 new cases with 95% CI of (2.1–6.1)/1000 years.ConclusionPeripheral neuropathy, chronic headaches and epilepsy disorders are major causes of morbidity in Sub-Saharan settings. There is an urgent need of more robust and powered studies to determine the incidence of these diseases.Electronic supplementary materialThe online version of this article (doi:10.1186/s12883-016-0732-y) contains supplementary material, which is available to authorized users.

Highlights

The burden of neurological diseases is increasing in developing countries
Study site and settings The study was conducted in Mukono district which lies in the central region of Uganda
Peripheral neuropathy followed by chronic headaches had the highest estimated incidence/1000 years

Summary

Introduction

There is a prominent scarcity of literature on the incidence of neurological diseases in sub-Saharan Africa. Neurological diseases contribute significantly to morbidity and mortality worldwide. The burden of neurological conditions in sub-Saharan Africa has been increasing over the years [3]. Neurological disorders contributed to 92 million disability-adjusted life-years (DALY) in 2005 and were projected to 103 million in 2030 worldwide [4]. The annual incidence of stroke has been estimated to be 316 per 100 000, and a prevalence of up to 315 per 100 000 with a three-year fatality of up to 84% in Africa [5]. Most data on mortality have been hospital-based, the majority of stroke deaths in the region are thought to occur at home [6]

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