Community survey of neurological disorders in Saudi Arabia: Results of the pilot study in Agrabiah

ABSTRACT

A pilot study of the Agrabiah area in Al-Khobar was undertaken to field test study methodologies and identify possible limitations and constraints to a planned community survey for neurological disorders in the Eastern Province of Saudi Arabia. The survey used a pre-tested questionnaire administered by trained personnel to all subjects living within 50 blocks randomly selected from the 198 inhabited ones in the area. Subjects with abnormal responses on screening were then evaluated by neurologists using specific guidelines and criteria to establish the diagnosis of neurological disease. One thousand four hundred and eighty-five subjects [98.3% of all eligible subjects] were screened 227 [15%] had abnormal responses. Of the 202 subsequently evaluated by neurologists, 178 had definite neurological disease. The overall crude prevalence rate [PR] per 1000 population for neurological morbidity was 120.5 [95% confidence limits [CL] 103.5 to 136.5]. Headache syndromes [PR 99.7, CL 83 to 114.7] were common. The other common disorders were seizures [PR 10.2, CL 5.1 to 15.3], peripheral nerve disorders [PR 2.7], and stroke [PR 2.0]. Mental retardation and cerebral palsy were the main pediatric problems with PR[s] of 1.4 and 0.7 respectively. Our results show that a community survey for neurological disorders is feasible in Saudi Arabia and the modified questionnaire was a good screening instrument [sensitivity 94.7%, specificity 96.8%]. However, the findings on the pattern and prevalence of neurological disorders need to be viewed with caution, particularly against the background of the scope of the study and the small number of subjects assessed. Cultural practices, local time and social events, and climatic conditions significantly affected community participation and the coverage achieved by the study. These factors should be considered when planning community surveys in Saudi Arabia and other environments with similar sociocultural settings