Global Health: Pediatric Neurology

Abstract

Neurologic disorders contribute significantly to both morbidity and mortality among children in resource-limited settings, but there are a few succinct studies summarizing the epidemiology of neurologic disorders in these settings. A review of available literature was performed to identify data on the prevalence, etiology, outcomes, and treatment of neurologic disorders in children in resource-limited settings. The burden of neurologic disorders in children is high in resource-limited settings. Barriers to optimal care include lack of trained personnel, limited access to diagnostic technology, and limited availability of drugs used to treat common conditions. Several solutions have been suggested to deal with these challenges including increased collaborations to train neurologists willing to practice in resource-limited settings and increased training of physician extenders or community health workers. Further studies are necessary to improve our understanding of the epidemiology of neurologic disorders in resource-limited settings. Future epidemiologic studies should incorporate multiple countries in resource-limited settings and utilize standardized definitions and methodologies to enable comparison across regions.

Longitudinal Cognitive Outcomes in Children With HIV in Zambia: 2-Year Outcomes From the HIV-Associated Neurocognitive Disorders in Zambia (HANDZ) Study

“…3 As increased access to antiretroviral therapy (ART) has reduced the incidence of opportunistic infections (OIs), there has been increasing concern regarding neurocognitive effects of HIV. [4][5][6][7] Multiple previous cross-sectional studies have demonstrated worse cognitive and developmental outcomes among children and adolescents living with HIV. Youth living with HIV show higher rates of neurocognitive deficits in executive function, memory, and language processing skills.…”

“…3 As increased access to antiretroviral therapy (ART) has reduced the incidence of opportunistic infections (OIs), there has been increasing concern regarding neurocognitive effects of HIV. 4–7…”

Decentralized, primary-care delivered epilepsy services in Burera District, Rwanda: Service use, feasibility, and treatment

“…In our study, patients with epilepsy were more likely to be children, and 85% of children under 10 who were seen at the MESH MH supported services were diagnosed with epilepsy. Globally, the burden of epilepsy is high among children [ 17 ]. In sub-Saharan Africa, it is estimated that over 90% of people with epilepsy are younger than 20 years old [ 1 ], and the prevalence of epilepsy in children is estimated to be between 3.6 and 44/1000, with higher rates in rural areas [ 17 ].…”

“…Globally, the burden of epilepsy is high among children [ 17 ]. In sub-Saharan Africa, it is estimated that over 90% of people with epilepsy are younger than 20 years old [ 1 ], and the prevalence of epilepsy in children is estimated to be between 3.6 and 44/1000, with higher rates in rural areas [ 17 ]. The most common risk factors for epilepsy in resource-limited countries has been attributed to birth-related trauma, traumatic brain injuries, and central nervous system (CNS) infections, as well as inadequate access to quality health services [ 1 ].…”

“…Children with epilepsy are at risk for behavioral disturbances [ 18 ] and reduced school attendance, as well as other consequences such as burns, falls and drowning. Service provision for children with epilepsy should focus not only on optimal seizure control, but also family psychoeducation and addressing the significant morbidity and social stigma which is associated with epilepsy [ 17 ].…”