Neurological disorders in rural Africa - a systematic approach

ABSTRACT

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: