Neurological Disease Surveillance in Cameroon, a Rural and Urban-Based Inout Patient Population Study
Clinical Neurology and Neuroscience
Volume 3, Issue 1, March 2019, Pages: 24-30
Received: Mar. 17, 2019;
Accepted: Apr. 17, 2019;
Published: May 31, 2019
Views 496 Downloads 86
Jacques Doumbe, Department of Neurology, University of Douala, Douala, Cameroon
Yacouba Njankouo Mapoure, Department of Neurology, University of Douala, Douala, Cameroon
Theophile Nyinyikua, Department of Neurology, University of Douala, Douala, Cameroon
Callixte Kuate, Department of Neurology, University of Douala, Douala, Cameroon
Katie Kompoliti, Department of Neurology, University of Douala, Douala, Cameroon
Hiral Shal, Department of Neurology, Columbia University, New York, NewYork, United States
Bichum Ouyang, Department of Neurology, University of Douala, Douala, Cameroon
Sara Calvo, Department of Neurology, University of Burgos, Burgos, Spain
Abel Fernandez-Sierra, Department of Neurology, University of Burgos, Burgos, Spain
Esther Cubo, Department of Neurology, University of Burgos, Burgos, Spain
Follow on us
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.
Neurological Disease, Surveillance, Cameroon
To cite this article
Yacouba Njankouo Mapoure,
Neurological Disease Surveillance in Cameroon, a Rural and Urban-Based Inout Patient Population Study, Clinical Neurology and Neuroscience.
Vol. 3, No. 1,
2019, pp. 24-30.
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Group GBDNDC. Global, regional, and national burden of neurological disorders during 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Neurol 2017; 16: 877-897.
Murray CJ, Lopez AD. Measuring the global burden of disease. N Engl J Med 2013; 369: 448-457.
Murray CJ, Vos T, Lozano R, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380: 2197-2223.
Bower JH, Asmera J, Zebenigus M, Sandroni P, Bower SM, Zenebe G. The burden of inpatient neurologic disease in two Ethiopian hospitals. Neurology 2007; 68: 338-342.
Callixte KT, Clet TB, Jacques D, Faustin Y, Francois DJ, Maturin TT. The pattern of neurological diseases in elderly people in outpatient consultations in Sub-Saharan Africa. BMC Res Notes 2015; 8: 159.
Preux PM, Druet-Cabanac M. Epidemiology and aetiology of epilepsy in sub-Saharan Africa. Lancet Neurol 2005; 4: 21-31.
Mukendi D, Lilo Kalo JR, Mpanya A, et al. Clinical Spectrum, Etiology, and Outcome of Neurological Disorders in the Rural Hospital of Mosango, the Democratic Republic of Congo. Am J Trop Med Hyg 2017; 97: 1454-1460.
Dewhurst F, Dewhurst MJ, Gray WK, et al. The prevalence of neurological disorders in older people in Tanzania. Acta Neurol Scand 2013; 127: 198-207.
Kurtzke JF. Neuroepidemiology. Ann Neurol 1984; 16: 265-277.
Cockerell OC, Sander JW, Shorvon SD. Neuroepidemiology in the United Kingdom. J Neurol Neurosurg Psychiatry 1993; 56: 735-738.
Tandi TE, Cho Y, Akam AJ, et al. Cameroon public health sector: shortage and inequalities in geographic distribution of health personnel. Int J Equity Health 2015; 14: 43.
Tegueu CK, Nguefack S, Doumbe J, Fogang YF, Mbonda PC, Mbonda E. The spectrum of neurological disorders presenting at a neurology clinic in Yaounde, Cameroon. Pan Afr Med J 2013; 14: 148.
Dewhurst F, Dewhurst MJ, Gray WK, et al. Rates of diagnosis and treatment of neurological disorders within a prevalent population of community-dwelling elderly people in sub-Saharan Africa. J Epidemiol Glob Health 2012; 2: 207-214.
Akinyemi RO, Izzeldin IM, Dotchin C, et al. Contribution of noncommunicable diseases to medical admissions of elderly adults in Africa: a prospective, cross-sectional study in Nigeria, Sudan, and Tanzania. J Am Geriatr Soc 2014; 62: 1460-1466.
Kompoliti K, Doumbe J, Mapoure YN, et al. Mortality and morbidity among hospitalized adult patients with neurological diseases in Cameroon. J Neurol Sci 2017; 381: 165-168.
Brinkhof MW, Boulle A, Weigel R, et al. Mortality of HIV-infected patients starting antiretroviral therapy in sub-Saharan Africa: comparison with HIV-unrelated mortality. PLoS Med 2009;6:e1000066.
Tsegaw M, Andargie G, Alem G, Tareke M. Screening HIV-associated neurocognitive disorders (HAND) among HIV positive patients attending antiretroviral therapy in South Wollo, Ethiopia. J Psychiatr Res 2017; 85: 37-41.
Marks M, Jarvis JN, Howlett W, Mabey DCW. Neurosyphilis in Africa: A systematic review. PLoS Negl Trop Dis 2017; 11: e0005880.
Walker R, Whiting D, Unwin N, et al. Stroke incidence in rural and urban Tanzania: a prospective, community-based study. Lancet Neurol 2010;9:786-792.
Tekle-Haimanot R, Abebe M, Gebre-Mariam A, et al. Community-based study of neurological disorders in rural central Ethiopia. Neuroepidemiology 1990; 9: 263-277.
Shakir R, Bergen D. International Classification of Diseases (ICD-11) and neurologic disorders: the future. Neurology 2013; 81: 182-183.
Van Heerden A, Barnabas RV, Norris SA, Micklesfield LK, van Rooyen H, Celum C. High prevalence of HIV and non-communicable disease (NCD) risk factors in rural KwaZulu-Natal, South Africa. J Int AIDS Soc 2017; 20.
Lekoubou A, Echouffo-Tcheugui JB, Kengne AP. Epidemiology of neurodegenerative diseases in sub-Saharan Africa: a systematic review. BMC Public Health 2014; 14: 653.
Dotchin C, Jusabani A, Gray WK, Walker R. Projected numbers of people with movement disorders in the years 2030 and 2050: implications for sub-Saharan Africa, using essential tremor and Parkinson's disease in Tanzania as an example. Mov Disord 2012; 27: 1204-1205; author reply 1207.
Stuck AE, Tenthani L, Egger M. Assessing population aging and disability in sub-Saharan Africa: lessons from Malawi? PLoS Med 2013; 10: e1001441.
Ba-Diop A, Marin B, Druet-Cabanac M, Ngoungou EB, Newton CR, Preux PM. Epidemiology, causes, and treatment of epilepsy in sub-Saharan Africa. Lancet Neurol 2014; 13: 1029-1044.
Ngugi AK, Bottomley C, Kleinschmidt I, et al. Prevalence of active convulsive epilepsy in sub-Saharan Africa and associated risk factors: cross-sectional and case-control studies. Lancet Neurol 2013; 12: 253-263.
Mung'ala-Odera V, White S, Meehan R, et al. Prevalence, incidence and risk factors of epilepsy in older children in rural Kenya. Seizure 2008; 17: 396-404.