Tropical ataxic neuropathy: Findings of a neuroepidemiological survey of Odeda, southwest Nigeria.

BACKGROUND: Tropical ataxic neuropathy seems to have dwindled in public health importance in Nigeria despite the high consumption of cassava-based meals by a huge proportion of people in local Nigerian communities. Yet a recent report suggest its persistence in the same ethnogeographic setting where it was first reported in Nigeria. Our objective was to investigate the prevalence of tropical ataxic neuropathy in Odeda, Ogun state, southwest Nigeria inhabited by a different ethnic group compared to Epe where the disease was first described. METHODS: A two-stage, cross-sectional survey of Odeda local government area for the prevalence and profile of toxiconutritional neurological disorders was carried out between May and June 2015. A screening instrument was applied by trained non - medical interviewers with positive responders further evaluated by a neurologist. RESULTS: 2392 individuals aged 18 years or older were screened and had a mean age of 37.2 ±â€¯16.1 years, were predominantly of Egba Yoruba ethnicity. Thirty nine cases of tropical ataxic neuropathy were diagnosed and crude prevalence rate was 16.3/1000 (95% CI 11.2-21.4/1000). Older age and rural residence were associated with higher prevalence. Distal sensory polyneuropathy was the most common feature whereas sensorineural deafness was the least common finding. CONCLUSION: This report provides evidence that tropical ataxic neuropathy persists and in a wider geographic spread. Thus tropical ataxic neuropathy still remains a significant public health importance and concerted efforts are required to mitigate or eradicate tropical ataxic neuropathy in southwest Nigeria and other regions of Africa affected by cassava- related toxiconutritional disorders.

Knowledge and perception of stroke amongst hospital workers in an African community.

BACKGROUND AND PURPOSE: Stroke is a growing public health problem worldwide. Hospital workers are sources of knowledge on health issues including stroke. The present study aimed at assessing the knowledge and perception of a sample of Nigerian hospital workers about stroke. METHODS: Hospital-based, cross-sectional survey. Respondents selected by systematic random sampling were interviewed using a 29-item pre-tested, structured, semi-closed questionnaire. RESULTS: There were 370 respondents (63% female, mean age: 34.4 +/- 7.5 years; 61% non-clinical workers). Twenty-nine per cent of respondents did not recognize the brain as the organ affected. Hypertension (88.6%) was the commonest risk factor identified; 13.8% identified evil spirit/witchcraft as a cause of stroke, whilst one-sided body weakness (61.9%) was most commonly identified as warning symptom. Hospital treatment was most preferred by 61.1% of respondents whilst spiritual healing was most preferred by 13.0%. In the bivariate analysis, higher level of education and being a clinical worker correlated with better stroke knowledge (P < 0.001). CONCLUSION: This study demonstrates gaps in the knowledge of these hospital workers about stroke, and treatment choice influenced by cultural and religious beliefs. Health education is still important, even, amongst health workers and stroke awareness campaigns may need to involve faith-based organizations.