Neurological disorders in Northern Tanzania: A 6-year prospective hospital-based case series

Abstract

Background:The burden of neurological disorders is large and altered by the HIV epidemic.
 Objectives: We describe the pattern of neurological disorders and their association with HIV infection in adult patients attending a consultant hospital in Northern Tanzania.
 Methods: In this prospective cross-sectional study, we collected data on adult neurological referrals over a 6-year period between 2007-13. The odds of HIV infection, across neurological categories adjusted for age and sex, was calculated.
 Results: Of 2037 participants, 54.8% were male and 45.2% were female. The median age of participants was 43 years. The results for HIV screening were available for 992/2037 (48.7%) patients, of whom 306 (30.8%) were seropositive. The most frequent neurological disorders were cerebrovascular disease (19.9%), paraplegia (13.6%), and peripheral neuropathies (8%). Taken together CNS infection accounted for 278/2037 (13.6%). The adjusted odds (aOR) of HIV infection was highest amongst infections; brain abscesses (aOR 107, 95% CI 35.1-470.4) and meningitis/encephalitis (aOR 40.1, 95% CI 13.6-172.9), but also raised in cerebrovascular disease, paraplegia, peripheral neuropathies, cranial nerve palsies, seizures, cerebllar disorders, movement disorders, motor neuron disease andheadache.
 Conclusion: The main pattern of neurological disorders in Northern Tanzania is presented. The odds of HIV infection was highest in CNS infections and in a wide range of non-communicable neurological disorders.
 Keywords: Tanzania; neurological; disorder; neurological disease; hospital; HIV

Advancing genetic testing for neurological disorders in Tanzania: importance, challenges, and strategies for implementation

“…Several studies conducted in Tanzania, including those in Dar es Salaam, Moshi, Kilimanjaro, and the University of Dar es Salaam, have identified over twenty neurological disorders (NDs) in urban populations, encompassing motor, muscular, and cognitive NDs ( Laizer et al, 2018 ; Adebayo et al, 2020 ; Siima et al, 2020 ; Stephano, 2021 ; Howlett et al, 2022 ). However, none of these studies employed genetic tests for diagnosis.…”

“…In contrast, the broader landscape of genetic testing for neurological disorders and diseases in adults in the northern Tanzania has shown limitations. While various neurological conditions such as stroke, infections, neuropathies, and movement disorders are prevalent, laboratory-based genetic testing is not yet a standard part of diagnostic procedures ( Howlett et al, 2022 ). Overall, there is a pressing need for the expansion of genetic testing capabilities and resources in Tanzania, especially in fields like epilepsy, movement disorders, neuropathies, ataxias and muscular dystrophies, to better address genetic disorders and contribute to improved healthcare outcomes.…”

Lack of association of Vascular Risk Factors with HIV-associated neurocognitive disorders in cART-treated adults aged ≥50 years in Tanzania

“…Aetiology includes endothelial dysfunction, blood brain barrier disruption or a combination of both [77] . Comparable HIV-speci c data are few, but a US study in younger PLWH with a high rate of uncontrolled HIV (40% Black, 41% pre-cART, median age 42) reported 24% had clinically signi cant WMD (68% any lesions) [78] .Conversely, 19.6% of individuals presenting with cerebrovascular disease in a Kilimanjaro tertiary centre were HIV positive (median age 43) [79] . Non-HIV community data, e.g.…”

Parkinson’s Disease in Sub-Saharan Africa: Pesticides as a Double-Edged Sword

“…The published prevalence of PD in SSA ranges from 7-67/100,000, with 30/100,000 reported in a large community-based study in Tanzania [ 2, 6 ]. The mean age of onset of PD in the latter study was 69.4 years [ 6 ], with one decade later a trend towards a lower age of onset at 62 (53–73) years [ 7 ]. A recent South African study involving 687 cases of PD in mixed race persons reported an onset age of 57.3 years.…”