Neurological Diseases in Karachi, Pakistan – Elevated Occurrence of Subacute Sclerosing Panencephalitis

Abstract

Neurological diseases, especially subacute sclerosing panencephalitis (SSPE), were surveyed in Karachi, Pakistan disclosing following major results. (1) Indirectly estimated prevalence rates of selected neurological disease entities were comparable with the rates from western countries and Japan in heredodegenerative diseases, but grossly elevated in infectious diseases. (2) Estimated mortality statistics for the Karachi community revealed highly elevated rates for infectious, parasitic and perinatal causes of death. (3) SSPE represented about 10% of inflammatory afflictions of the cerebral parenchyma, its incidence rate being about 100% times more than that observed in developed countries. A case-control study preliminarily showed that infants who later contract SSPE have unhealthy mothers, are born small, and have various occurrences of ill health from birth to the onset of SSPE. (4) Age at the onset of measles was very young in the cases as well as in controls, unlike the average young age at onset of cases only in developed countries. Measles contracted at young age is a well known risk factor to SSPE. Whereas few children in developed countries acquire measles at such an early age, many Karachi children do. Elevated occurrence of SSPE is probably conditioned by such age patterns of measles infection, together with other risk factors more common in Karachi due to poorer health standards. A proper immunization programme is urgently needed to control measles and SSPE.

Clinical presentation of subacute sclerosing panencephalitis in Papua New Guinea

“…Although SSPE has been shown to account for a substantial proportion of childhood neourodegenerative conditions in developing countries (Kondo et al. 1988; Radhakrishnan et al.…”

Incidence and Prevalence of Myasthenia gravis in the County of the Coast and Gorski kotar, Croatia, 1976 through 1996¹

“…Worldwide [7][8][9][10][11][12][13][14][15][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33], prevalence of MG differs widely from 25 to 142 per 1,000,000 population, and has increased from 1950 to the 1990s (table 5). Phillips and Torner [3] concluded, from the analysis of 33 population-based studies, that there was a trend for an increase in incidence and prevalence over time, and the regression line for preva- …”

Elevated Ratio of Late Measles among Subacute Sclerosing Panencephalitis Patients in Karachi, Pakistan

“…Previously [10] we reported an annual ele vated incidence of SSPE in the general popu lation of Karachi of 6.35 X 10~6. Interesting ly, this value is 50-to 100-fold the values reported for various Western countries and Japan before vaccination against the measles virus was introduced or expanded.…”