Neurological Disease Surveillance in Cameroon, a Rural and Urban-Based Inout Patient Population Study

Abstract

Background: There is a paucity of literature on the burden of neurological diseases in sub-Saharan Africa.Objective: To create a registry and surveillance of neurological diseases from urban and rural health centers in Cameroon. Methods: Retrospective review of medical records of inpatients and outpatients from two urban public hospitals in Douala and two rural health care centers, from 2013 to 2015 was conducted. In the urban areas, the diagnosis was made by a neurologist but this was not the case in the rural areas. The following variables were analyzed: demographics, medical center characteristics, presenting neurological complaint, medical history, neurological diagnosis, death and disability. Neurological diseases were classified according to ICD-10. Results: Out of 20,131 medical charts available (13% from the rural area), 4,187 cases (20.7%) with neurological complaints were identified and reviewed, mean age 48.67 + 18.62 years, females 54.7%, 188 children (4.4%). The most frequent neurological complaints were: paresis/weakness (G.82, 25.2%) and headache (R.51, 22.0%). The most common concurrent medical history was hypertension (I10, 40.0%), and HIV (B20, 16.45%). The most common neurological diagnoses were cerebrovascular disease (G45, G46, 51.5%), and infection (B50, G00, G04, G06, 24.13%) in adults, and epilepsy (G40, 64.0%) in children. Death due to neurological cause was recorded in 428 patients (19.1%), and disability in 1,072 (57.2%). Neurodegenerative diseases were exclusively diagnosed in urban areas. Conclusion: Population aging and changes in the distribution of risk factors have accelerated the prevalence of non-communicable diseases such as cerebrovascular disease. However, additional work to characterize the nature of diagnosis, treatment and care is important to advance quality of care in the adult and pediatric neurological disorders. A health policy geared towards prevention and neurological training for health professionals is warranted.