Prevalence of Parkinsonism and Parkinson's disease in Qena governorate/Egypt: a cross-sectional community-based survey

Abstract

Background and purpose:In a previous study we found a high crude prevalence rate (CPR) for Parkinson's disease (PD) in Assiut governorate/Egypt. We therefore surveyed a second Nile valley governorate (Qena) to provide confirmatory evidence for the high prevalence rate of PD in Egypt.Subjects and methods:10 areas in Qena governorate were selected by random sampling to recruit 8027 inhabitants. Positive cases were identified using a modified screening questionnaire, the unified Parkinson disease rating scale (UPDRS), mini-mental state examination (MMSE) and the non-motor symptoms scale (NMSS) for PD.Results:Forty-four patients were identified with Parkinsonism, giving a CPR of 548/105 inhabitants. Among them, 35 patients were diagnosed as PD with CPR of 436/105; three cases were diagnosed as drug-induced Parkinsonism with CPR 37/105; two cases had atherosclerotic Parkinsonism with CPR 25/105.Age-specific CPR of PD among population aged ≥ 50 years old was 2534/105.The highest age-specific CPR was recorded among subjects ≥ 75 years old. The CPR showed a tendency to be higher in males than females, urban than rural areas and industrial than non-industrial areas (503 vs 363/105, 474 vs 389/105 and 655 vs 312/105, respectively). There was a significantly higher CPR among illiterate than literate persons (1982 vs 299/105 with P = 0.00001). About one quarter of patients had cognitive impairment. All cases had positive symptoms in at least one or more NMS Domains.Conclusion:The overall prevalence of PD disease is high in Nile valley governorates of Upper Egypt compared to other Arabic countries.