Prevalence of cervical and lumbosacral compressive radiculopathies in Qena governorate/Egypt: Population-based survey.

OBJECTIVES: The aim of the study was to estimate the crude prevalence rate (CPR) of compressive radiculopathies in Qena governorate/Egypt. PATIENTS AND METHODS: 10 areas in Qena governorate were selected by random sampling, involving 9303 inhabitants with 57.3% urban residents and 42.7% rural residence. Patients were diagnosed using a screening questionnaire for the diagnosis of cervical and lumbosacral radiculopathies. All positive cases were referred to Qena University Hospital where they underwent full neurological examination, neuro-imaging, and neurophysiological investigations. RESULTS: Out of 9303 inhabitants included in the study (1057 families), 49 cases were recruited positive on initial survey and 32 cases were confirmed after clinical examination, neuroimaging and neurophysiological examinations, giving a CPR of 10.1/1000 in those aged over 30 years. Compressive radiculopathy was more common in males than females (13 versus 6/1000) and in rural than urban populations (15 versus 7/1000). No cases were recruited below 30 years old. The highest age specific prevalence was at ≥60 years with a CPR of 26/1000. 11 cases had cervical radiculopathy while 21 cases had lumbosacral radiculopathy (CPR of 3.7 and 6.6/1000 respectively). The highest age specific CPR for males was earlier than females at 50-59 versus ≥60 years. CONCLUSION: The overall CPR of compressive radiculopathy in the general population in Qena governorate/Egypt is similar for cervical radiculopathy but higher for lumbosacral radiculopathy than a previous Egyptian study but mid-way compared to other countries.

Prevalence of neuromuscular disorders in Qena governorate/Egypt: population-based survey.

BACKGROUND: Few epidemiological studies of the prevalence of neuromuscular disorders have been undertaken. The aim of the study was to estimate the prevalence of the most common types of neuromuscular disorders in Qena governorate/Egypt. METHODS: A random sample was taken from 11 districts, involving 9303 inhabitants with 57.3% urban residents and 42.7% rural residence. Patients were diagnosed using a screening questionnaire for the diagnosis of neuromuscular disorders. All positive cases were referred to Qena University hospital where they underwent full clinical, electrophysiological, and laboratory investigations. RESULTS: Out of 9303 participants 448 cases were identified positive during survey. Four hundred and twenty-six cases proved to have neuromuscular disorders giving a crude prevalence rate (CPR) of 4.57%; 408 cases had definite neuropathy and 18 cases had muscular disorders equivalent to CPR of 4.39% and 193/105 respectively. There was a higher prevalence in the rural than urban population. The CPR of focal compression neuropathies was 1.8%, with the majority of cases having carpal tunnel syndrome (CPR = 1.67%). CPR of diabetic neuropathy was 1.67%. The CPR of compressive radiculopathy was 0.34%. Traumatic nerve injury had a CPR 0.06%. The lifetime prevalence of Bell's palsy was 0.16%. Hereditary motor and sensory neuropathy had a CPR 0.08%. The CPR of idiopathic neuropathy was 0.09% and Infective Leprotic neuropathy was 0.04%. Five patients were diagnosed as having muscular dystrophy and another 5 patients had myotonia with CPR of 54/105 for each. Two cases of myasthenia gravis and another two cases with systemic myopathy were recorded giving a CPR of 21/105. CONCLUSION: The overall CPR of neuromuscular disorders in the general population in Qena governorate/Egypt was higher than reported in other countries.

Prevalence of Bell's palsy in Qena Governorate, Egypt.

BACKGROUND AND PURPOSE: There have been few studies to estimate the prevalence of Bell's palsy (BP) in Arab countries. A community-based study was conducted to estimate the prevalence, incidence rates, precipitating factors, and outcome of BP in Qena Governorate, Egypt. SUBJECTS AND METHODS: A door-to-door survey was carried out, with random sampling of 10 districts, involving 9303 inhabitants, 51.1% males and 48.9% females. Seventeen subjects were positive in screening questionnaire and referred to Qena University hospital and were subjected to a full clinical examination, House Brackmann's Facial grading system. RESULTS: In a total population of 9303 individuals, 15 cases were confirmed as having BP giving a prevalence rate (PR) 161/10(5) for all ages 95%CI (80-243). It was slightly but not significantly higher among women and the rural community. The incidence rate of BP was 107/10(5). The highest age-specific rate was 40-49 years age. The most frequent precipitating factors for an episode of BP were exposure to air draft in 40%, physical stress (13.3%), and upper respiratory tract infection (13.3%). Moreover, 46.7% had predisposing risk factors, DM and hypertension in 33.3%. Sixty percent of cases had complication and poor outcome. CONCLUSION: The overall prevalence and incidence rates of BP in Qena governorate were high. This could be related to the variation in day and night temperature in our community and the susceptibility to air draft exposure during the night. The high frequency of poor outcome among studied cases suggests that better local guidelines should be implemented to recognize and treat BP.

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

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 548/10(5) inhabitants. Among them, 35 patients were diagnosed as PD with CPR of 436/10(5); three cases were diagnosed as drug-induced Parkinsonism with CPR 37/10(5); two cases had atherosclerotic Parkinsonism with CPR 25/10(5).Age-specific CPR of PD among population aged ≥ 50 years old was 2534/10(5).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 363/10(5), 474 vs 389/10(5) and 655 vs 312/10(5), respectively). There was a significantly higher CPR among illiterate than literate persons (1982 vs 299/10(5) 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.

Prevalence of mild cognitive impairment and dementia among the elderly population of Qena Governorate, Upper Egypt: a community-based study.

BACKGROUND: There are only a few reports which provide prevalence rates of mild cognitive impairment (MCI) and dementia specifically in Arabic countries. OBJECTIVE: This study is aimed at estimating the prevalence of MCI and dementia among subjects aged ≥60 years using door-to-door survey in Qena Governorate/Egypt. METHODS: We conducted a door-to-door survey with multistage probability random sampling. Screening of all subjects aged ≥60 years (n = 691) employed a simple questionnaire including changes in memory, behavior, and daily activity, Memory and Executive Screening test (MES)as well as the Mini-Mental State Examination. Suspected cases were referred to the hospital for full clinical examination, DSM-IV diagnostic criteria, Hachinski Ischemic Score, neuroimaging, and laboratory investigations if indicated. RESULTS: Of the 691 participants, 12 cases had MCI, giving a crude prevalence rate (CPR) of 1.74/100 and 35 were identified as positive for dementia with a CPR of 5.07/100. The highest age-specific prevalence rates were recorded among subjects ≥85 years old (100/100). The CPRs were significantly higher in urban than rural areas (7.1 versus 3.27/100, respectively; p = 0.03), in industrial areas than non-industrial areas (13.23 versus 1.99; p = 0.00001), and in illiterate than literate participants (10.12 versus 2.25/100; p = 0.00001). CONCLUSION: Overall, the prevalence rate of MCI and dementia were lower in Qena/Egypt than in other countries. Advanced age, illiteracy, and living in an industrial area were found to be associated with dementia.