The burden of inpatient neurologic disease in two Ethiopian hospitals

Bower, James H.; Asmera, J; Zebenigus, Mehila; Sandroni, Paola; Bower, Susan M.; Zenebe, Guta

doi:10.1212/01.wnl.0000252801.61190.e8

Cited by 46 publications

(67 citation statements)

References 7 publications

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“…Previous studies conducted in Tanzania demonstrated a huge diff erence in the apparent incidence of stroke when comparing rural and urban settings (4.5% [9] and 25% [10] of all neurological admissions). However, Bower et al (2007) observed only minor diff erences (rural 16.2% and 21.8% urban) [5]. Th e present analysis also appears to indicate a signifi cantly larger percentage of stroke patients in the urban catchment area; however, diff erences being less pronounced.…”

Section: Vascular Diseasesupporting

confidence: 41%

“…Th is is particularly striking in rural African catchment areas where only very sparse data are available with previous neurological prevalence studies in rural areas lacking the crucial diagnostic feature of cross-sectional imaging [3][4][5]. Consecutively the present survey allows for the fi rst time a comparison between the disease pattern of cranial pathologies in a rural and an urban setting of eastern Africa.…”

Section: Introductionmentioning

confidence: 81%

“…Th e results of previous studies in Africa [3][4][5]10] led to expectations of high numbers of cerebral infections/infestations in cCT/cMRI. Furthermore, high HIV prevalence should contribute to a high number of HIV-related cerebral infections and infestations like toxoplasmosis [11,12] or cryptococcosis [13,14].…”

Section: Diagnoses Compatible With Cerebral Infections/infestationsmentioning

confidence: 99%

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Imaging-based disease pattern in a consecutive series of cranial CTs and MRIs in a rural and an urban Tanzanian hospital: a comparative, retrospective, neuroradiological analysis

Maier

Doppler

Gasser

et al. 2010

Wien Klin Wochenschr

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The prevalence of neurological diseases and cranial pathologies in sub-Saharan Africa remains a very little investigated field. This study aims at providing an imaging-based overview of cranial pathologies in two Tanzanian hospitals and at identifying possible differences in the spectrum of diseases between rural and urban African populations. At rural Haydom Lutheran Hospital (Manyara region) the data of 726 patients were included in a retrospective survey. At urban Aga Khan Hospital (Dar es Salaam) the data of 1975 patients who had undergone Computed Tomography (CT) and of 537 Magnetic Resonance Imaging (MRI) patients were obtained. All three surveys showed a clear male preponderance within the populations. The median age of the patients was higher in the city (urban CT 48 years; range 0-95/MRI 39 years; 0.1-89; rural CT 32 years; 0-102). In the urban series stroke, extracranial infections, cerebral atrophy and tumours formed the main groups of diagnoses. Amongst rural patients traumatic pathologies, followed by stroke and cerebral infections/infestations were the most common diagnoses. The most striking differences were noticed with cases compatible with cerebral infections/infestations and hydrocephalus being reported more frequently in the rural population. On the other hand stroke and cerebral atrophy were more frequent amongst urban patients. In the rural catchment area the data of 51 HIV-positive CT patients could be obtained, showing a clear female preponderance. Within the urban HIV-positive subgroup of CT patients (n = 57), the gender distribution was almost equal. Furthermore, in both HIV-positive populations the proportion "compatible with cerebral infections/infestations" was higher than amongst the overall study populations. In conclusion, cranial pathologies seem to differ widely in rural and urban areas of Tanzania in particular with respect to cerebral infections and vascular disease.

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Section: Vascular Diseasesupporting

confidence: 41%

Section: Introductionmentioning

confidence: 81%

Section: Diagnoses Compatible With Cerebral Infections/infestationsmentioning

confidence: 99%

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Imaging-based disease pattern in a consecutive series of cranial CTs and MRIs in a rural and an urban Tanzanian hospital: a comparative, retrospective, neuroradiological analysis

Maier

Doppler

Gasser

et al. 2010

Wien Klin Wochenschr

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“…Neurological disorders explained 3% of global disability-adjusted life-years (DALYs) and 5.6% of global years lived with disability [5]. In 2005, neurological disorders contributed to 92 million DALYs and are expected to increase to 103 million in 2030 [6, 7]. …”

Section: Introductionmentioning

confidence: 99%

Spectrum of Disease and Prescription Pattern for Outpatients with Neurological Disorders: An Empirical Pilot Study in Bangladesh

et al. 2017

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Background: Neurological disorders represent one of the most prominent causes of morbidity and mortality that adversely affect the lifestyle of patients and a major percentage of these diseases exists in developing countries. Purpose: The objective of this study was to examine the prevalence and prescription pattern for outpatients with neurological disorders in Bangladesh. Methods: The study was conducted on 1,684 patients in 6 hospitals (National Institute of Neurosciences and Hospital, Dhaka Medical College and Hospital, Bangabandhu Sheikh Mujib Medical University, Shaheed Suhrawardy Medical College, Sir Salimullah Medical College, and Apollo Hospitals Dhaka) of the Dhaka City from March 2014 to June 2015. Data were collected through a predesigned questionnaire from the patients that contain information about gender, age, marital status, occupation, residential status, affected disease, self-medicated medicines, and prescribed medicines. Results: Out of 1,684 patients, 28.38% patients were aged 51–60 years and male, 57.19% predominance. The study exposed headache and migraine for 29.75% patients, followed by stroke for 23.93% patients and seizure for 7.07% patients. Genetic reason for the neurological disorders was seen only among 12.35% patients. In this study, 16.98% patients had been affected by neurological disorders for more than 2 years and 19% of patients for less than 6 months. Most extensively prescribed medicines were multivitamins and multiminerals used by 17.89% of patients followed by nonsteroidal anti-inflammatory drugs and other analgesic by 14.84%; afterwards antiulcerants were used by 12.62%, subsequently anticoagulants were used by 11.61% followed by antihyperlipidemic medicines by 10.26% and antiepileptic drugs by 8.08% of patients. The crucial reasons for the selection of prescribed medicines were the confidence that patients had with the physician’s prescribed medicines, which was shown for 40.97% patients and knowledge of the medicines was reported for 35.04% patients. The period of prescribed medicine usage was 1–3 months for 39.73% patients and 3–6 months for 29.16% patients. The patient’s compliance for prescribed medicines was satisfactory for 34.56% patients, good for 28.15% patients, and side effects were reported for 23.22% patients. Conclusion: In Bangladesh, it is not surprising to note that neurological diseases are more prevalent than other different diseases among different age groups and genders. Headache and migraine, stroke and seizure are most frequently encountered neurological disorders here. Treatment procedure of these disorders is not quite suitable due to the anomalies of health care management systems. Appropriate management of the health care system, especially the placement of hospital and community pharmacy can overcome the existing inconsistencies as well as increase the knowledge, awareness, and perception of the patients about health and neurological disorders.

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“…HIV or TB infection) [2,3] . Several recent hospital-based studies from Africa document that neurological disorders account for 18-25% of medical admissions, suggesting a much heavier burden of disease in the community than reported by the GBDS [4][5][6][7] . The only three population-based assessments of adult neurological disease in Africa predated the HIV epidemic [8][9][10] .…”

Section: Introductionmentioning

confidence: 99%

A Screening Instrument to Measure the Prevalence of Neurological Disability in Resource-Poor Settings

et al. 2009

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Background: Very little is known about the prevalence of neurological morbidity in Africa. Much of this is due to the difficulty in performing epidemiological surveys in these settings. A screening instrument to measure neurological disease in resource-poor settings was designed by the World Health Organization in 1981, but several problems with it have subsequently been recognized. Methods: We created a new screening instrument that addressed problems with the original instrument identified by prior investigators, and that included questions to identify diseases of public health significance and broad neurological syndromes. This new instrument was tested in an outpatient setting in Moshi, Tanzania. We compared the sensitivity and specificity of the new instrument to the original 1981 WHO instrument. Results: We tested the survey on 128 participants. Of these, 63 had neurological diagnoses, 21 had pain-only diagnoses and 44 had no neurological diagnoses. The survey was well received by all the participants. A nonmedical interviewer was trained to administer and interpret a simple neurological examination without difficulty. The median time to administer the instrument was 13 min (interquartile range 10–17 min). The sensitivity of the new instrument improved that of the WHO instrument from 98.4 to 100%, but the difference was not statistically significant (p = 0.44). However, the specificity significantly improved from 29.2 to 61.0% (p = 0.001). Conclusions: We have developed a screening instrument to measure the prevalence of neurological morbidity in resource-poor settings. It was shown to be highly feasible, highly sensitive, and more specific than the existing WHO instrument.

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The burden of inpatient neurologic disease in two Ethiopian hospitals

Cited by 46 publications

References 7 publications

Imaging-based disease pattern in a consecutive series of cranial CTs and MRIs in a rural and an urban Tanzanian hospital: a comparative, retrospective, neuroradiological analysis

Imaging-based disease pattern in a consecutive series of cranial CTs and MRIs in a rural and an urban Tanzanian hospital: a comparative, retrospective, neuroradiological analysis

Spectrum of Disease and Prescription Pattern for Outpatients with Neurological Disorders: An Empirical Pilot Study in Bangladesh

A Screening Instrument to Measure the Prevalence of Neurological Disability in Resource-Poor Settings

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