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Ikanga J, Reyes A, Kaba D, Akilimali P, Mampunza S, Epenge E, Gikelekele G, Kavugho I, Tshengele N, Hammers DB, Alonso A. Prevalence of suspected dementia in a sample of adults living in Kinshasa-Democratic Republic of the Congo. Alzheimers Dement 2023; 19:3783-3793. [PMID: 36880714 PMCID: PMC10483015 DOI: 10.1002/alz.13003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 01/10/2023] [Accepted: 01/22/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND The prevalence of dementia in Sub-Saharan Africa, particularly in French-speaking countries, has received limited attention. This study investigates the prevalence and risk factors of suspected dementia in elderly adults in Kinshasa, Democratic Republic of the Congo (DRC). METHODS A community-based sample of 355 individuals over 65 years old was selected using multistage probability sampling in Kinshasa. Participants were screened using the Community Screening Instrument for Dementia, Alzheimer's Questionnaire, Geriatric Depression Scale, Beck Anxiety Inventory, and Individual Fragility Questionnaire, followed by clinical interview and neurological examination. Suspected dementia diagnoses were made based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria including significant cognitive and functional impairments. Prevalence and odds ratios (ORs) with 95% confidence interval (CI) were calculated using, respectively, regression and logistic regression. RESULTS Among 355 participants (mean age 74, SD = 7; 51% male), the crude prevalence of suspected dementia was 6.2% (9.0% in women and 3.8% in men). Female sex was a significant factor associated with suspected dementia [OR = 2.81, 95% CI (1.08-7.41)]. The prevalence of dementia increased with age (14.0% after 75 years and 23.1% after 85 years), with age being significantly associated with suspected dementia [OR = 5.42, 95% CI (2.86-10.28)]. Greater education was associated with a lower prevalence of suspected dementia [OR = 2.36, 95% CI (2.14-2.94), comparing those with ≥7.3 years of education to those with <7.3 years of education]. Other factors associated with the prevalence of suspected dementia included being widowed (OR = 1.66, 95% CI (1.05-2.61), being retired or semi-retired (OR = 3.25, 95% CI (1.50-7.03)], a diagnosis of anxiety [OR = 2.56, 95% CI (1.05-6.13)], and death of a spouse or a relative after age 65 [OR = 1.73, 95% CI (1.58-1.92)]. In contrast, depression [OR = 1.92, 95% CI (0.81-4.57)], hypertension [OR = 1.16, 95% CI (0.79-1.71)], body mass index (BMI) [OR = 1.06, 95% CI (0.40-2.79)], and alcohol consumption [OR = 0.83, 95% CI (0.19-3.58)] were not significantly associated with suspected dementia. CONCLUSIONS This study found a prevalence of suspected dementia in Kinshasa/DRC similar to other developing countries and Central African countries. Reported risk factors provide information to identify high-risk individuals and develop preventive strategies in this setting.
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Affiliation(s)
- Jean Ikanga
- Emory University School of Medicine, Department of Rehabilitation Medicine, Atlanta, Georgia, 30322, USA
- University of Kinshasa and Catholic University of Congo, School of Medicine, Kinshasa, Department of Psychiatry, B.P. 7463 Kinshasa I, Democratic Republic of Congo
| | - Anny Reyes
- Emory University School of Medicine, Department of Rehabilitation Medicine, Atlanta, Georgia, 30322, USA
| | - Didine Kaba
- University of Kinshasa, School of Public Health, Department of Epidemiology, B.P. 7463 Kinshasa I, Democratic Republic of Congo
| | - Pierre Akilimali
- University of Kinshasa, School of Public Health, Department of Epidemiology, B.P. 7463 Kinshasa I, Democratic Republic of Congo
| | - Samuel Mampunza
- University of Kinshasa and Catholic University of Congo, School of Medicine, Kinshasa, Department of Psychiatry, B.P. 7463 Kinshasa I, Democratic Republic of Congo
| | - Emmanuel Epenge
- University of Kinshasa, Department of neurology, Kinshasa, B.P. 7463 Kinshasa I, Democratic Republic of Congo
| | - Guy Gikelekele
- University of Kinshasa and Catholic University of Congo, School of Medicine, Kinshasa, Department of Psychiatry, B.P. 7463 Kinshasa I, Democratic Republic of Congo
| | - Immaculee Kavugho
- Memory clinic of Kinshasa, Kinshasa, B.P. 7463 Kinshasa I, Democratic Republic of Congo
| | - Nathan Tshengele
- University of Kinshasa and Catholic University of Congo, School of Medicine, Kinshasa, Department of Psychiatry, B.P. 7463 Kinshasa I, Democratic Republic of Congo
| | - Dustin B. Hammers
- Indiana university, Department of neurology, Indianapolis, IN 46202, USA
| | - Alvaro Alonso
- Emory University, Department of Epidemiology, Rollins School of Public Health, Atlanta, GA, 30307, USA
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Varga E, Battamir U, Szegedi I, Hudák L, Kovács N, Nagy AC. Seasonal patterns in the epidemiology of Bell's palsy in Hungary. Front Neurol 2023; 14:1188137. [PMID: 37409014 PMCID: PMC10318583 DOI: 10.3389/fneur.2023.1188137] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/06/2023] [Indexed: 07/07/2023] Open
Abstract
Introduction Epidemiological data on Bell's palsy are vital for elucidating disease prevalence and enhancing therapeutic options. Our objective was to explore the prevalence and possible risk factors associated with Bell's palsy recurrence in the Clinical Center of the University of Debrecen service area. Secondary data analysis was performed using hospital discharge data, including patient information and comorbidities. Methods Data was obtained from the Clinical Center of the University of Debrecen, on Bell's palsy patients who were treated at the hospital between January 1, 2015 and December 31, 2021. Multiple logistic regression analysis was used to examine the factors associated with Bell's palsy recurrence. Results Of the 613 patients analyzed, 5.87% had recurrent paralysis, and the median time interval between episodes was 315 days. Hypertension was significantly associated with Bell's palsy recurrence. Moreover, seasonal distribution analysis revealed that the number of Bell's palsy episodes was higher in colder seasons, with spring and winter having a significantly higher number of episodes than summer and autumn. Discussion This study provides insights into the prevalence and associated risk factors of Bell's palsy recurrence, which could aid in its management and help reduce the long-term consequences of the disease. Further research is necessary to determine the precise mechanisms underlying these findings.
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Affiliation(s)
- Eszter Varga
- Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ulambayar Battamir
- Department of Health Informatics, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - István Szegedi
- Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Lilla Hudák
- Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Nóra Kovács
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Attila Csaba Nagy
- Department of Health Informatics, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
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Epidemiology of Cerebral Palsy among Children and Adolescents in Arabic-Speaking Countries: A Systematic Review and Meta-Analysis. Brain Sci 2022; 12:brainsci12070859. [PMID: 35884667 PMCID: PMC9313288 DOI: 10.3390/brainsci12070859] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/22/2022] [Accepted: 06/27/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Studies on cerebral palsy among children and adolescents in Arabic-speaking countries are scarce. In this systematic review, we aimed to describe the epidemiology of cerebral palsy among children and adolescents in Arabic-speaking countries in terms of prevalence, risk factors, motor types, and rehabilitation. Methods: Six key bibliographic databases were searched for relevant literature published to 17 July 2021. Titles and abstracts were screened for potential inclusion and two independent reviewers screened the full texts of potential articles following pre-defined inclusion/exclusion criteria. The included studies were evaluated independently by three reviewers. The risk of bias was assessed, and data were extracted and analysed. Results: A total of 32 studies from 7 countries met our inclusion criteria. The prevalence of cerebral palsy in Arabic-speaking countries was 1.8/1000 live births (95% CI: 1.2–2.5). Spastic cerebral palsy was the most common motor type, representing 59.8% (95% CI: 46.2–72.7) of pooled estimates. This included children with spastic quadriplegia, diplegia, and hemiplegia; 25.1% (95% CI: 18.2–32.8), 16.2% (95% CI: 11.4–23.3), and 10.4% (95% CI: 7.3–13.8), respectively. Consanguinity was high and represented 37.7% (95% CI: 29.3–46.6). Only one included study reported the types of rehabilitation received (e.g., physiotherapy and assistance devices). Conclusions: This paper provides a summary of the epidemiology of cerebral palsy in Arabic-speaking countries and highlights areas for future research. There is still a substantial knowledge gap on the epidemiology of cerebral palsy in these regions. Countries in the Arab region should follow examples of countries that have successfully established cerebral palsy registries to generate evidence on epidemiology of cerebral palsy and opportunities for prevention.
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Roushdy T, Aref H, Kesraoui S, Temgoua M, Nono KP, Gebrewold MA, Peter W, Gopaul U, Belahsen MF, Ben-Adji D, Melifonwu R, Pugazhendhi S, Woodcock N, Mohamed MH, Rossouw A, Matuja S, Ruanda MK, Mhiri C, Saylor D, Nahas NE, Shokri H. Stroke services in Africa: What is there and what is needed. Int J Stroke 2022; 17:972-982. [PMID: 35034522 DOI: 10.1177/17474930211066416] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Over the past few years, the incidence and prevalence of stroke has been rising in most African countries and has been reported as one of the leading causes of morbidity and mortality. To study this problem, we need to realize the quality and availability of stroke care services as a priori to improve them. METHODS AND RESULTS In this study, we investigated the availability of different stroke-related services in 17 countries from different African regions. An online survey was conducted and fulfilled by stroke specialists and included primary prevention, acute management, diagnostic tools, medications, postdischarge services, and stroke registries. The results showed that although medications for secondary prevention are available, yet many other services are lacking in various countries. CONCLUSION This study displays the deficient aspects of stroke services in African countries as a preliminary step toward active corrective procedures for the improvement of stroke-related health services.
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Affiliation(s)
- Tamer Roushdy
- Neurology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hany Aref
- Neurology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Selma Kesraoui
- Department of Neurology, Blida Hospital University, Blida, Algeria
| | - Michael Temgoua
- Institute of Applied Neurosciences and Functional Rehabilitation, Bethesda Hospital, Yaoundè, Cameroon
| | - Kiatoko Ponte Nono
- Initiative Plus Hospital Center, Kinshasa, Democratic Republic of the Congo
| | | | - Waweru Peter
- Kenyatta University Teaching, Referral & Research Hospital, Nairobi, Kenya
| | - Urvashy Gopaul
- University of Mauritius, Moka, Mauritius.,KITE-University Health Network (UHN), Toronto, ON, Canada
| | - Mohammed Faouzi Belahsen
- Neurology Department, Hassan II University Hospital, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | | | - Rita Melifonwu
- Stroke Rehabilitation, Stroke Action Nigeria, Abuja, Nigeria
| | | | | | | | | | - Sarah Matuja
- Department of Internal Medicine, Bugando Medical Centre/Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Mark Koba Ruanda
- Emergency Medicine Department, Mnazi Mmoja Hospital, Zanzibar, Tanzania
| | - Chokri Mhiri
- Department of Neurology, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Deanna Saylor
- Department of Medicine, University Teaching Hospital, Lusaka, Zambia.,Department of Neurology, School of Medicine, The Johns Hopkins University, Baltimore, MD, USA
| | - Nevine El Nahas
- Neurology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hossam Shokri
- Neurology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Tsige S, Moges A, Mekasha A, Abebe W, Forssberg H. Cerebral palsy in children: subtypes, motor function and associated impairments in Addis Ababa, Ethiopia. BMC Pediatr 2021; 21:544. [PMID: 34861837 PMCID: PMC8641229 DOI: 10.1186/s12887-021-03026-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 11/24/2021] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Although, there is no population-level data in Ethiopia, a previous retrospective hospital-based study identified CP as the most common developmental disability in children. The overall aim of this study is to describe the clinical spectrum of CP in Tikur Anbessa Specialized Hospital in Addis Ababa, including CP subtype, gross and fine motor function, presence and pattern of associated impairments, and possible risk factors in children aged 2 to 18 years. METHODS A hospital-based descriptive cross-sectional study conducted- July - September of 2018 among 207 children with suspected motor symptoms. The Surveillance of CP in Europe (SCPE) decision tree was used as a guideline for inclusion and evaluation was by standardized questionnaire and clinical examination. Descriptive, bivariate and multivariate statistical analyses, Chi-square test, crudes association and adjusted odds ratio with 95% confidence interval employed. RESULT One hundred seventy four children who fulfilled the clinical criteria were included. Half (50.6%) were under the age of 5 years with a mean age of 5.6 (SD 3.6) years; 55.2 were male. The majority had bilateral spastic CP (60.4%) followed by unilateral spastic CP 21.8%, dyskinetic CP 10.4%, and ataxic CP 3.4%; 4% were unclassifiable. Of the children, 95.4% had speech difficulty, 87.4% learning disabilities, 60.9% epilepsy, 24.7% visual impairment and 8.6% hearing impairment. On gross motor function (GMFCS) and manual ability (MACS) classification systems, 75.3% of the children had level IV and V functional impairment. More than 80% of the mothers had complications during delivery Half of the neonates did not cry immediately after birth,44% were resuscitated with bag mask ventilation at birth and 64% immediately admitted to NICU. During the first month of life, 50% had infection, 62% had trouble feeding, 49.4% had difficulty breathing, 35% had seizure and 13.8% had jaundice. CONCLUSION The severe forms of CP predominate; most children are dependent on their parents for routine activities of daily living and cannot communicate well. Multidisciplinary care approaches and focused functional habilitation services are needed. Causal relationships cannot be drawn from these data but findings make a strong argument for improving maternal and child health care.
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Affiliation(s)
- Selamenesh Tsige
- Department of Pediatrics and Child Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Ayalew Moges
- Department of Pediatrics and Child Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Amha Mekasha
- Department of Pediatrics and Child Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Workeabeba Abebe
- Department of Pediatrics and Child Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Hans Forssberg
- Department of Women's and Children's Health, Karolinska Institute and Astrid Lindgren Children's Hospital, Stockholm, Sweden
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Elsherif M, Esmael A. Hippocampal atrophy and quantitative EEG markers in mild cognitive impairment in temporal lobe epilepsy versus extra-temporal lobe epilepsy. Neurol Sci 2021; 43:1975-1986. [PMID: 34406537 DOI: 10.1007/s10072-021-05540-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 07/26/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Cognitive impairment in temporal lobe epilepsy is widely acknowledged as one of the most well-known comorbidities. This study aimed to explore cognitive impairment and to determine the potential clinical, radiological, and quantitative electroencephalography markers for cognitive impairment in temporal lobe epilepsy patients versus extra-temporal lobe epilepsy. METHODS Forty-five patients with temporal lobe epilepsy and forty-five patients with extra-temporal lobe epilepsy were recruited for an administered digit span test, verbal fluency test, mini-mental state examination, digital symbol test, and Montreal cognitive assessment. Also, they were subjected to magnetic resonance imaging assessment for hippocampal atrophy and a quantitative electroencephalography assessment for electroencephalography markers (median frequency, peak frequency, and the alpha-to-theta ratio). RESULTS Patients with extra-temporal lobe epilepsy showed non-significant higher epilepsy durations and a higher frequency of seizures. Temporal lobe epilepsy patients showed a more statistically significant family history of epilepsy (37.7%), more history of febrile convulsions (13.3%), higher hippocampal atrophy (17.8%), and lower cognitive scales, especially mini-mental state examination and Montreal cognitive assessment; lower digital symbol test, verbal fluency test, and backward memory of digit span test. Also, temporal lobe epilepsy patients had a strong negative correlation with electroencephalography markers: median frequency, peak frequency, and the alpha-to-theta ratio (r = - 0.68, P < 0.005 and r = - 0.64, P < 0.005 and r = - 0.66, P < 0.005 respectively). CONCLUSION Cognitive impairment in patients with temporal lobe epilepsy was correlated with hippocampal atrophy and quantitative electroencephalography abnormalities, especially peak frequency, median frequency, and alpha-to-theta ratio that could be used alone for the identification of early cognitive impairment. TRIAL REGISTRATION Clinicaltrials.gov: NCT04376671.
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Affiliation(s)
- Mohammed Elsherif
- Department of Neurology, Mansoura Faculty of Medicine, Mansoura University, Mansoura, 35516, Dakahlia, Egypt.
| | - Ahmed Esmael
- Department of Neurology, Mansoura Faculty of Medicine, Mansoura University, Mansoura, 35516, Dakahlia, Egypt
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Abdel Hamid OI, Khayal EESH, Tolba SAR, Orabi EE. Maternal Δ-aminolevulinic acid dehydratase 1-2 genotype enhances fetal lead exposure and increases the susceptibility to the development of cerebral palsy. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:44709-44723. [PMID: 32710353 DOI: 10.1007/s11356-020-10182-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 07/16/2020] [Indexed: 06/11/2023]
Abstract
Limited epidemiologic studies questioned the association between pre- and postnatal lead exposure and the development of cerebral palsy (CP). Moreover, the genotypes of δ-aminolevulinic acid dehydratase (δ-ALAD) in CP patients and their mothers and their association to the blood lead levels (BLLs) were not previously studied. This study aimed to evaluate the association between δ-ALAD gene polymorphism and BLL in cases of CP and their mothers. A case control study was carried out on 23 CP cases and equal number of healthy matched controls. The mothers of the included children were asked to answer a questionnaire involving the baseline clinical and demographic characteristics. Also, questionnaires were done to detect the sources of environmental lead exposure and screen lead exposure during the pregnancy period. BLL, δ-ALAD enzyme activity, and genetic analysis for ALAD G177C were done for each child and his mother. There was significant (p < 0.001) elevation of BLL in CP cases and their mothers that was positively correlated (r = 0.436, p < 0.05). There were progressive decreases in δ-ALAD activity with increasing BLL in both children and mothers (p < 0.05). There were non-significant (p > 0.05) differences between CP and the control group regarding frequency of ALAD G177C genotypes, while there was a significant (p = 0.04) increase in the frequency of ALAD 1-2 (GC) genotype in the mothers of the CP group associated with high BLL and significant decrease in δ-ALAD activity (p < 0.001). The study can indicate the significance of δ-ALAD gene polymorphism in the prenatal exposure to lead and the affection of the developing brain, pointing to the importance of controlling lead in pregnant women especially those with ALAD 1-2 genotype.
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Affiliation(s)
- Omaima Ibrahim Abdel Hamid
- Forensic Medicine & Clinical Toxicology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
| | | | | | - Eman Elshahat Orabi
- Public Health & Community Medicine Departments, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Khalil H, Chahine LM, Siddiqui J, Salari M, El-Jaafary S, Aldaajani Z, Abu Al-Melh M, Mohammad TM, Abu Snineh M, Syed NA, Bhatt M, Habib MA, Habahbeh M, Tabbal SD, Jeon B, Bajwa JA. Parkinson's Disease in the Middle East, North Africa, and South Asia: Consensus from the International Parkinson and Movement Disorder Society Task Force for the Middle East. JOURNAL OF PARKINSON'S DISEASE 2020; 10:729-741. [PMID: 32176653 PMCID: PMC8203232 DOI: 10.3233/jpd-191751] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 02/09/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Understanding the regional needs and available healthcare resources to treat Parkinson's disease (PD) is essential to plan appropriate future priorities. The International Parkinson and Movement Disorder Society (MDS) Task Force for the Middle East was established to raise awareness and promote education across the region on PD and other movement disorders. Broadly, the task force encompasses the countries of the Middle East but has included North Africa and South Asia as well (MENASA). OBJECTIVE To create a list of needs and priorities in the advancement of PD in MENASA countries based on consensuses generated by the MDS task force for the Middle East. METHODS A Strengths Weaknesses-Opportunities-Threats (SWOT) analysis was conducted by the task force members to generate consensus about PD care this region. RESULTS Eight overarching principles emerged for the consensus statement on current needs: more movement disorders specialists, multidisciplinary care, accurate epidemiologic data, educational programs, availability of drugs, and availability of more advanced therapy, enhanced health care resources and infrastructure, and greater levels of awareness within the general population and among health care professionals. CONCLUSION This pilot study sheds light on unmet needs for providing care to people with PD in the MENASA region. These data offer directions on priorities to increase awareness of PD, to develop better infrastructure for research and management of PD, to foster healthcare policy discussions for PD and to provide educational opportunities within these countries.
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Affiliation(s)
- Hanan Khalil
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Lana M. Chahine
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Junaid Siddiqui
- Department of Neurology, University of Missouri, Columbia, MO, USA
| | - Mehri Salari
- Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Zakiyah Aldaajani
- Neurology Unit, King Fahad Medical Military Complex, Dahran, Saudi Arabia
| | | | | | | | | | - Mohit Bhatt
- Kokilaben Dhirubhai Ambani Hospital & Medical Research Institute, Mumbai, India
| | - Mohammad Ahsan Habib
- Department of Neurology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Majed Habahbeh
- Department of Medicine, Neurology Section, King Hussein Medical Centre, Amman, Jordan
| | - Samer D. Tabbal
- Department of Neurology, Parkinson & Movement Disorders Program, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Beomseok Jeon
- Department of Neurology, Movement Disorders Center, Seoul National University, Seoul, South Korea
| | - Jawad A. Bajwa
- Department of Neurology, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
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OBEMBE OLAJIDEBENJAMIN, ADEYEMO SURAJU, OGUN OLUWAYEMICECILIA, IJAROGBE GRACETEMITAYO. The relationship between coping styles and depression among caregivers of children with cerebral palsy in Nigeria, West Africa. ARCH CLIN PSYCHIAT 2019. [DOI: 10.1590/0101-60830000000215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Epidemiology of Alzheimer's Disease and Dementia in Arab Countries: A Systematic Review. Behav Neurol 2019; 2019:3935943. [PMID: 31772681 PMCID: PMC6854962 DOI: 10.1155/2019/3935943] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 05/25/2019] [Accepted: 09/16/2019] [Indexed: 11/17/2022] Open
Abstract
Background/Objectives Contrary to popular belief, the condition of dementia is not an actual discrete disease, but rather a group of symptoms, most notable of which is the disturbance of memory and social ability, often severe enough to impair daily functioning. As a result, it has been a major cause of functional deterioration among varying populations in the world. This study is aimed at reviewing the epidemiology of dementia in Arab countries in terms of its prevalence, distribution, and risk factors. Methods A systematic literature review was conducted using articles published in PubMed, Embase, Scopus, and other local journals between 1990 and 2018. After applying the inclusion and exclusion criteria, a total of 18 studies were concluded to be eligible for the review. Results Prevalence studies demonstrated that dementia is indeed a prevalent condition in Arab countries, ranging between 1.1% and 2.3% among age groups of 50 years and older, as well as between 13.5% and 18.5% among age groups of 80 years and above. However, these results are not different from those of many other countries in the world. Moreover, prevalence was found to vary depending on sociodemographic characteristics. Major risk factors of dementia included hypertension, low income, and low education, while the risk of developing dementia is increased by obesity, diabetes mellitus, and cardiovascular risk factors. Despite the growing evidence regarding the epidemiological distribution and determinants of dementia worldwide, studies from the Arab region remain scarce. Conclusion This systematic review highlights the need for population-based studies to provide necessary information for developing preventive and curative strategies specific to the Arab region.
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El-Tallawy HN, Farghaly WM, Abdelhamed MA, Badry R, Rageh TA, Soliman WT, Abdulghani KO, Hassan M, Sobhy S, Shehata GA. Prevalence of migraine in Upper Egypt. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2019. [DOI: 10.1186/s41983-019-0067-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Zaitoun AM, Elsayed DAF, Ramadan BM, Gaffar HAA. Assessment of the risk factors and functional outcome of delirium in acute stroke. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2019. [DOI: 10.1186/s41983-019-0059-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Farghaly WM, Abd Elhamed MA, Hassan EM, Soliman WT, Yhia MA, Hamdy NA. Prevalence of childhood and adolescence epilepsy in Upper Egypt (desert areas). THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2018; 54:34. [PMID: 30532513 PMCID: PMC6245138 DOI: 10.1186/s41983-018-0032-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 10/09/2018] [Indexed: 11/10/2022] Open
Abstract
Background A high prevalence of epilepsy in children is frequently found in developing countries. Objective This study aimed to determine the prevalence and clinical pattern of childhood and adolescence epilepsy in Upper Egypt. Methods This is a door-to-door study conducted on all inhabitants < 18 years in Al Kharga district and Al Qusier city (36,195 subjects). The study was conducted through two stages; every stage consisted of two phases (screening and diagnostic). Results Lifetime prevalence of childhood and adolescence epilepsy (children < 18 years) in Upper Egypt was 9.7/1000, with higher prevalence among children < 12 years (10.8/1000) than adolescents (7.2/1000). The age-specific prevalence was highest in early childhood (12.01/1000) and least at adolescence (7.2/1000). More than half of the patients (59.4%) had idiopathic epilepsy. The most frequent etiology for structural/metabolic epilepsy was perinatal complications, particularly in infancy, followed by central nervous system (CNS) infections, in childhood, and post-traumatic epilepsy in adolescence. Partial seizures were more frequent in infancy, while generalized seizures were more frequent in late childhood and adolescence. Generalized tonic-clonic seizures (GTCS) were the most frequent type of seizures. Conclusion Prevalence of childhood and adolescence epilepsy in Upper Egypt was not so much different from other developing countries. Idiopathic epilepsy was more prevalent than structural/metabolic cases. Perinatal complications, CNS infections, and head injury were the most frequent etiologies, and generalized tonic-clonic seizures were the most frequent seizure type. Electronic supplementary material The online version of this article (10.1186/s41983-018-0032-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | - Enas M Hassan
- 2Department of Neurology, Minia University, Minya, Egypt
| | - Wael T Soliman
- 2Department of Neurology, Minia University, Minya, Egypt
| | - Mohamed A Yhia
- 2Department of Neurology, Minia University, Minya, Egypt
| | - Nermin A Hamdy
- 2Department of Neurology, Minia University, Minya, Egypt
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Movement Disorders and Deep Brain Stimulation in the Middle East. World Neurosurg 2018; 113:e314-e319. [PMID: 29452314 DOI: 10.1016/j.wneu.2018.02.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 02/02/2018] [Accepted: 02/05/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Deep brain stimulation (DBS) is a well-established neuromodulation therapy for advanced Parkinson disease, essential tremor and dystonia. In as much as this therapy is being developed in the Middle East, a better understanding of the incidence and prevalence of movement disorders, health care, and social framework is required for the region. METHODS We reviewed current literature on the incidence and prevalence of various movement disorders in the Middle East amenable to DBS surgery. We also assessed recent efforts to develop DBS in the region. RESULTS Available data on incidence and prevalence of movement disorders in the Middle East are old, inconclusive, and conflicting. We identify key areas such as cultural background, availability of accessible information, training, infrastructure, and public support groups in the region that may pose challenges. CONCLUSIONS The Middle East is projected to be a growing market for neuromodulation. The available data on incidence and prevalence of movement disorders is from studies that were small, partial, and old, with inconsistent results, highlighting the need for newer, better-designed, and larger studies. DBS in the Middle East will need assessment of incidence and prevalence of movement disorders, existing challenges to its application, and focused efforts on key opportunities to foster development of DBS for this underserved region. This article is an attempt to identify and explore these challenges and propose solutions in anticipation.
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Bakr NM, Hashim NA, Awad A, Sarhan AA. Association between Interleukin-18 promoter polymorphisms and risk of ischemic stroke: A case-control study. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2018. [DOI: 10.1016/j.ejmhg.2017.08.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Harden CL. The Plausibility of an Association Between Maternal Obesity and Onset of Childhood Epilepsy: A Well-Rounded, Robust Argument or a Thin Epidemiologic Association? Epilepsy Curr 2017; 17:288-290. [PMID: 29225542 PMCID: PMC5716498 DOI: 10.5698/1535-7597.17.5.288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Abas O, Abdelaziem F, Kilany A. Clinical Spectrum of Cerebral Palsy and Associated Disability in South Egypt: A Local Survey Study. Open Access Maced J Med Sci 2017; 5:37-41. [PMID: 28293314 PMCID: PMC5320905 DOI: 10.3889/oamjms.2017.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 01/23/2017] [Accepted: 01/24/2017] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Cerebral palsy is the most common cause of motor disability in children with a prevalence of 2-10/1,000 live births in the developing areas. AIM The epidemiology, clinical picture, and associated comorbidities in CP have been extensively studied in high-resource countries, but in low-resource areas, including Africa, those studies are still lacking. METHODS Cerebral palsy cases were prospectively recruited from every physiotherapy centre in Bani-Mazar city, Egypt, in a cross-sectional study from May 2015 to November 2015. RESULTS Two hundred cases were enrolled with a prevalence of 1 per 1000 live births. Within the study population, 72.5% were the spastic type, 16% were dyskinetic, 7% were ataxic, and 4.5% were hypotonic. The most common comorbidities were cognitive impairment and epilepsy affecting 77% and 38%, respectively. CONCLUSION Cerebral palsy in developing countries has a higher prevalence and different clinical profile regarding severity and associated disability. The perinatal and high-quality neonatal care together with physical therapy and rehabilitation programs is still lacking in developing countries.
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Affiliation(s)
- Osama Abas
- Physical Therapy, Ministry of Health, Cairo, Egypt
| | - Faten Abdelaziem
- Department of Physical Therapy for Growth and Development Disorders in Children and Its Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Ayman Kilany
- Department of Research on Children with Special Needs, National Research Centre, Cairo, Egypt
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Elshahidi MH, Elhadidi MA, Sharaqi AA, Mostafa A, Elzhery MA. Prevalence of dementia in Egypt: a systematic review. Neuropsychiatr Dis Treat 2017; 13:715-720. [PMID: 28293113 PMCID: PMC5345900 DOI: 10.2147/ndt.s127605] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND With the growing prevalence of dementia worldwide, two-third of the people with dementia are projected to be from the developing countries by 2050. AIM This study reviews the literature regarding dementia prevalence in Egypt. METHODS Six databases were systematically searched from their dates of inception till July 2016. Studies published in English and reporting dementia prevalence among nonhospitalized individuals after clinical examinations were considered eligible. References were screened independently by two reviewers in two steps: 1) abstract screening and 2) full-text reviewing. In addition, quality of the included studies was assessed using the Newcastle-Ottawa scale. RESULTS Of the 1,630 references retrieved, six studies (n=28,029 participants) met our inclusion criteria. In all studies, dementia was ascertained using a three-phase survey (Phase I: screening, Phase II: clinical diagnosis, Phase III: laboratory investigations). The dementia prevalence ranged from 2.01% to 5.07%. Dementia increased with age, with the rapid increase among those aging ≥80. Also, its prevalence was higher among illiterate groups than among educated groups. Included studies were of low risk of bias. CONCLUSION Dementia prevalence in Egypt demands including people with dementia in the health care system and promoting the awareness of dementia among the public. Also, more epidemiological studies in this field are needed.
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Subramony SH. Degenerative Ataxias: challenges in clinical research. Ann Clin Transl Neurol 2016; 4:53-60. [PMID: 28078315 PMCID: PMC5221462 DOI: 10.1002/acn3.374] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 10/17/2016] [Accepted: 10/18/2016] [Indexed: 01/05/2023] Open
Abstract
The degenerative ataxias are a very heterogeneous group of disorders that include numerous genetic diseases as well as apparently “sporadic” entities. There has been an explosion of discoveries related to genetic defects and related pathomechanisms that has brought us to the threshold of meaningful therapies in some but not all of these diseases. There also continues to be lack of knowledge of the causation of disease in a sizeable proportion of these patients. The overall rarity of ataxias as a whole and certainly of the individual genetic entities together with slow and variable progression and variable prognosis in juxtaposition with a rapid development of possible therapies in the horizon such as gene replacement and gene knock‐down strategies places the ataxias in a unique position distinct from other similar neurodegenerative diseases. The pace of laboratory research seems not matched by the pace of clinical research and clinical trial readiness. This review summarizes the author's views on the various challenges in translational research in ataxias and hopes to stimulate further thought and discussions on how to bring real help to these patients.
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Affiliation(s)
- Sub H Subramony
- Department of Neurology University of Florida College of Medicine and McKnight Brain Institute Gainesville Florida
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Khedr EM, Fawi G, Abbas MAA, Abo El-Fetoh N, Zaki AF, Gamea A, Al Attar G. Prevalence of neuromuscular disorders in Qena governorate/Egypt: population-based survey. Neurol Res 2016; 38:1056-1063. [DOI: 10.1080/01616412.2016.1243640] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Eman M. Khedr
- Faculty of Medicine, Department of Neuropsychiatry, Assiut University, Assiut, Egypt
| | - Gharib Fawi
- Faculty of Medicine, Department of Neuropsychiatry, Sohag University, Sohag, Egypt
| | | | - Noha Abo El-Fetoh
- Faculty of Medicine, Department of Neuropsychiatry, Assiut University, Assiut, Egypt
| | - Ahmed F. Zaki
- Faculty of Medicine, Department of Neuropsychiatry, South Valley University, Qena, Egypt
| | - Ayman Gamea
- Faculty of Medicine, Department of Neuropsychiatry, South Valley University, Qena, Egypt
| | - Ghada Al Attar
- Faculty of Medicine, Department of Public Health and Community Medicine, Assiut University, Assiut, Egypt
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Bearden DR, Monokwane B, Khurana E, Baier J, Baranov E, Westmoreland K, Mazhani L, Steenhoff AP. Pediatric Cerebral Palsy in Botswana: Etiology, Outcomes, and Comorbidities. Pediatr Neurol 2016; 59:23-9. [PMID: 27114082 PMCID: PMC4912921 DOI: 10.1016/j.pediatrneurol.2016.03.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Revised: 03/03/2016] [Accepted: 03/04/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Cerebral palsy is the most common cause of motor dysfunction in children worldwide and is often accompanied by multiple comorbidities. Although cerebral palsy has been studied extensively in high-resource settings, there are few published studies on cerebral palsy etiology, outcomes and comorbidities in low-resource settings. METHODS Children with cerebral palsy were prospectively enrolled from inpatient and outpatient settings at a referral center in Gaborone, Botswana, in a cross-sectional study conducted from 2013 to 2014. Cerebral palsy etiology, outcomes, and comorbidities were determined through caregiver interviews, review of medical records, and direct physical examination. RESULTS Sixty-eight children with cerebral palsy were enrolled. Subjects were 41% male, with a median age of 4 years (interquartile range = 2 to 7). The most common etiologies for cerebral palsy in our cohort were intrapartum hypoxic events (18%), postnatal infections (15%), prematurity (15%), focal ischemic strokes (10%), and prenatal infections (10%). Severe motor impairment was common, with the most severe category present in 41%. The predominant comorbidities were cognitive impairment (84%), epilepsy (77%), and visual impairment (46%). CONCLUSIONS Cerebral palsy in Botswana has different etiologies and is associated with poorer outcomes and higher prevalence of comorbidities than what has been reported in high-resource settings. Further studies are necessary to determine optimal preventative and treatment strategies in this population.
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Affiliation(s)
- David R Bearden
- Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Botswana-UPenn Partnership, University of Pennsylvania, Philadelphia; Department of Pediatrics, University of Botswana, Gaborone, Botswana.
| | | | - Esha Khurana
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - James Baier
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Esther Baranov
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Kate Westmoreland
- Botswana-UPenn Partnership, University of Pennsylvania, Philadelphia; Department of Pediatrics, University of Botswana, Gaborone, Botswana; Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Loeto Mazhani
- Department of Pediatrics, University of Botswana, Gaborone, Botswana
| | - Andrew P Steenhoff
- Botswana-UPenn Partnership, University of Pennsylvania, Philadelphia; Department of Pediatrics, University of Botswana, Gaborone, Botswana; Division of Infectious Disease, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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El-Tallawy HN, Farghaly WMA, Badry R, Metwally NA, Shehata GA, Rageh TA, El Hamed MA, Kandil MR. Prevalence of multiple sclerosis in Al Quseir city, Red Sea Governorate, Egypt. Neuropsychiatr Dis Treat 2016; 12:155-8. [PMID: 26834477 PMCID: PMC4716737 DOI: 10.2147/ndt.s87348] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic and disabling disorder with considerable social effects and economic sequelae. It is one of the major causes of disability in young adults. OBJECTIVES This study aimed at detecting the prevalence of MS among the population of Al Quseir city. METHODS This study is a part of door-to-door survey of major neurological disorders that was conducted in Al Quseir city, Red Sea Governorate, Egypt. The sample size was 33,285 persons. The youngest patient was 17 years old. The number of people at and above 17 years of age was 21,827. They were screened by three neurologists. Then, the positive cases were subjected to meticulous clinical evaluation by three staff members of Department of Neurology, Assiut University Hospital, Egypt. Essential investigations were done. RESULTS A total of three cases of MS were diagnosed with an age-specific prevalence ≥17 years of 13.7/100,000.
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Affiliation(s)
- Hamdy N El-Tallawy
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Wafaa M A Farghaly
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Reda Badry
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Nabil A Metwally
- Department of Neurology and Psychiatry, Al Azhar University Hospital, Assiut Branch, Assiut, Egypt
| | - Ghaydaa A Shehata
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Tarek A Rageh
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Mohamed Abd El Hamed
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Mahmoud R Kandil
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
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El Tallawy HN, Farghaly WM, Rageh TA, Saleh AO, Mestekawy TA, Darwish MM, Abd El Hamed MA, Ali AM, Mahmoud DM. Construction of standardized Arabic questionnaires for screening neurological disorders (dementia, stroke, epilepsy, movement disorders, muscle and neuromuscular junction disorders). Neuropsychiatr Dis Treat 2016; 12:2245-53. [PMID: 27621635 PMCID: PMC5012614 DOI: 10.2147/ndt.s109328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
A screening questionnaire is an important tool for early diagnosis of neurological disorders, and for epidemiological research. This screening instrument must be both feasible and valid. It must be accepted by the community and must be sensitive enough. So, the aim of this study was to prepare different Arabic screening questionnaires for screening different neurological disorders. This study was carried out in three stages. During the first stage, construction of separate questionnaires designed for screening the five major neurological disorders: cerebrovascular stroke, dementias, epilepsy, movement disorders, and muscle and neuromuscular disorders were done. Validation of the screening questionnaires was carried out in the second stage. Finally, questionnaire preparation was done in the third stage. Questions with the accepted sensitivity and specificity in each questionnaire formed the refined separate questionnaires.
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Affiliation(s)
| | | | - Tarek A Rageh
- Department of Neurology and Psychiatry, Faculty of Medicine
| | | | | | - Manal Mm Darwish
- Public Health Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | | | - Anwar M Ali
- Department of Neurology and Psychiatry, Faculty of Medicine
| | - Doaa M Mahmoud
- Department of Neurology and Psychiatry, Faculty of Medicine
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Kakooza-Mwesige A, Forssberg H, Eliasson AC, Tumwine JK. Cerebral palsy in children in Kampala, Uganda: clinical subtypes, motor function and co-morbidities. BMC Res Notes 2015; 8:166. [PMID: 25902796 PMCID: PMC4421914 DOI: 10.1186/s13104-015-1125-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 04/15/2015] [Indexed: 01/13/2023] Open
Abstract
Background Cerebral palsy (CP) is a common chronic childhood disorder worldwide. There is limited information about the CP panorama in sub-Saharan Africa. Our aim was to describe the clinical subtypes, gross and fine motor functions and presence of co-morbidities in a group of children with CP attending a tertiary hospital in Uganda. Methods Children with CP in the age range of 2-12 years visiting the paediatric CP clinic at Mulago Hospital, Kampala, were enrolled. Screening and inclusion were based on a three-stage procedure: i) Two screening questions from the Ten Question Screen; ii) Clinical assessments adapted from the Surveillance for Cerebral Palsy in Europe (SCPE); iii) Clinical examinations and diagnoses of subtype, severity level and co-morbidities. Caregivers were interviewed using questionnaires to provide information on child’s medical history and co-morbidities. Co-morbidity scores were calculated for each child. Results One hundred and thirty five children with CP were enrolled (72 males, 63 females, median age 3 years 5 months, IQR-2 years 4 months-5 years 6 months). Bilateral spastic type was commonest (45%); moderate impairment in gross motor function was present in 43%, with comparable numbers (37%) in the mild and severely impaired fine motor function groups. The severe gross and fine motor function levels were seen in the bilateral spastic and dyskinetic CP subtypes. Signs of learning disability (75%) and epilepsy (45%) were the commonest co-morbidities. Higher co-morbidity scores were obtained in children with dyskinetic CP and severe levels of gross and fine motor function. There was a significant difference in distribution of the co-morbidity scores between the CP subtypes, gross motor and fine motor function levels (p <0.001). Signs of speech and language impairments were associated with bilateral spastic CP and severe gross and fine motor dysfunction (p < 0.05). Conclusions Bilateral spastic CP was the main clinical subtype, with signs of learning disability and epilepsy as major causes of co-morbidity. The severity of gross and fine motor function levels was related to severity of clinical CP subtypes. Our findings imply a higher occurrence of birth asphyxia or post natally acquired infections. Improvement in emergency obstetric and postnatal care may reduce this burden. Electronic supplementary material The online version of this article (doi:10.1186/s13104-015-1125-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Angelina Kakooza-Mwesige
- Department of Paediatrics & Child Health, Makerere University College of Health Sciences, P O Box 7072, Kampala, Uganda. .,Department of Women's & Children's Health, Astrid Lindgren Children's Hospital, Neuropediatric Research Unit, Karolinska Institutet, Stockholm, Sweden.
| | - Hans Forssberg
- Department of Women's & Children's Health, Astrid Lindgren Children's Hospital, Neuropediatric Research Unit, Karolinska Institutet, Stockholm, Sweden.
| | - Ann-Christin Eliasson
- Department of Women's & Children's Health, Astrid Lindgren Children's Hospital, Neuropediatric Research Unit, Karolinska Institutet, Stockholm, Sweden.
| | - James K Tumwine
- Department of Paediatrics & Child Health, Makerere University College of Health Sciences, P O Box 7072, Kampala, Uganda.
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El Tallawy HN, Farghaly WM, Badry R, Hamdy NA, Shehata GA, Rageh TA, Metwally NA, Hassan EM, Elsayed SS, Yehia MA, Soliman WT. Epidemiology and clinical presentation of stroke in Upper Egypt (desert area). Neuropsychiatr Dis Treat 2015; 11:2177-83. [PMID: 26346729 PMCID: PMC4552260 DOI: 10.2147/ndt.s87381] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Stroke is a common cause of morbidity and mortality worldwide. Four out of five strokes occur in the low- and middle-income countries. This study aims to find lifetime prevalence of stroke in Upper Egypt and to identify clinical presentations and possible risk factors of stroke in this population. METHODS This is a door-to-door (every door) study conducted on all inhabitants in Al Kharga district (representative of western desert) and Al Quseir city (representative of eastern desert). The study was conducted in two stages, and every stage consisted of three phases (screening, diagnostic, and investigatory). RESULTS The total lifetime prevalence of stroke was 8.5/1,000 in the population aged 20 years and more. It increased with advancing age and was higher among males than females among all age groups except in the childbearing period (20 years to <40 years of age). Lifetime prevalence of ischemic stroke (7.2/1,000) was higher than hemorrhagic stroke (1.1/1,000). Hemiparesis and hemiplegia were the commonest presentation of stroke. Headache, vomiting, and vertigo were found to be significantly more common accompaniments of hemorrhagic stroke. The most common risk factor was hypertension, followed by hyperlipidemia and diabetes mellitus. CONCLUSION The total lifetime prevalence of stroke in the population aged 20 years and more in Upper Egypt (desert area) lies within the range that is recorded in developing countries. Clinical presentation and risk factors are similar to those recorded from developing and developed countries.
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Affiliation(s)
- Hamdy N El Tallawy
- Department of Neurology and Psychiatry, Assiut University, Assiut, Egypt
| | - Wafaa M Farghaly
- Department of Neurology and Psychiatry, Assiut University, Assiut, Egypt
| | - Reda Badry
- Department of Neurology and Psychiatry, Assiut University, Assiut, Egypt
| | - Nermin A Hamdy
- Department of Neurology, El Minia University, El-Minia City, Egypt
| | - Ghaydaa A Shehata
- Department of Neurology and Psychiatry, Assiut University, Assiut, Egypt
| | - Tarek A Rageh
- Department of Neurology and Psychiatry, Assiut University, Assiut, Egypt
| | - Nabil A Metwally
- Department of Neurology, Al-Azhar University (Assuit Branch), Assiut, Egypt
| | - Enas M Hassan
- Department of Neurology, El Minia University, El-Minia City, Egypt
| | - Sayed S Elsayed
- Department of Neurology, El Minia University, El-Minia City, Egypt
| | - Mohamed A Yehia
- Department of Neurology, El Minia University, El-Minia City, Egypt
| | - Wael T Soliman
- Department of Neurology, El Minia University, El-Minia City, Egypt
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Benamer HTS, Bredan A. The epidemiology of myasthenia gravis in Arab countries: a systematic review. Muscle Nerve 2014; 51:144-5. [PMID: 25088247 DOI: 10.1002/mus.24350] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Hani T S Benamer
- Neurology Department, New Cross Hospital, Wolverhampton, UK; Department of Neurology, Queen Elizabeth Neuroscience Centre, Birmingham, UK
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Abd-Allah F, Moustafa RR. Burden of stroke in Egypt: current status and opportunities. Int J Stroke 2014; 9:1105-8. [PMID: 25041503 DOI: 10.1111/ijs.12313] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 05/20/2014] [Indexed: 11/30/2022]
Abstract
Middle East and North Africa (MENA) countries have a diversity of populations with similar life style, dietary habits, and vascular risk factors that may influence stroke risk, prevalence, types, and disease burden. Egypt is the most populated nation in the Middle East with an estimated 85.5 million people. In Egypt, according to recent estimates, the overall prevalence rate of stroke is high with a crude prevalence rate of 963/100,000 inhabitants. In spite of disease burden, yet there is a huge evidence practice gap. The recommended treatments for ischemic stroke that are guideline include systematic supportive care in a stroke unit or stroke center is still deficient. In addition, the frequency of thrombolysis in Egypt is very low for many reasons; the major one is that the health insurance system is not covering thrombolysis therapy in nonprivate sectors so patients must cover the costs using their own personal savings; otherwise, they will not receive treatment. Another important factor is the pronounced delay in prehospital and in hospital management of acute stroke. Improvement of stroke care in Egypt should be achieved through multi and interdisciplinary approach including public awareness, physicians' education, and synergistic approach to stroke care with Emergency Medical System.
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El-Tallawy HN, Farghaly WM, Shehata GA, Badry R, Rageh TA. Epileptic and cognitive changes in children with cerebral palsy: an Egyptian study. Neuropsychiatr Dis Treat 2014; 10:971-5. [PMID: 24920910 PMCID: PMC4045262 DOI: 10.2147/ndt.s59600] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Cerebral palsy (CP) is the most frequent cause of motor handicap among children. AIM OF THE STUDY We aim to study the relation of epilepsy in children with CP to various risk factors that affect the development of seizures. PATIENTS AND METHODS In a cross-sectional, descriptive, population-based, case-control study, 98 children with CP (48 children with CP with epilepsy, and 50 children with CP without epilepsy) were compared with 180 children without CP or seizures. The children lived in two regions in Egypt: the Al-Kharga District-New Valley and El-Quseir city-Red Sea. These cases were subjected to meticulous neurological assessment, brain magnetic resonance imaging, electroencephalography, and Stanford-Binet (4th edition) examination. Multinomial logistic regression was used to assess the risk factors. RESULTS Epilepsy was diagnosed in 48.9% of all cases of CP. Mental subnormality was observed more frequently in children with epilepsy than in those without epilepsy (84.6% versus 66.7%). The frequency of epilepsy was highest in patients with the spastic quadriplegic type of illness (58.3%). Multinomial logistic regression revealed that prematurity (<32 weeks of pregnancy), low birth weight (<2.5 kg at birth), neonatal seizures, jaundice, and cyanosis were significantly associated with CP with epilepsy. CONCLUSION CP is associated with a high percentage of seizure disorders. Prematurity, low birth weight, neonatal seizures, cyanosis, and jaundice are significant risk factors among patients with CP with epilepsy compared to patients with CP without epilepsy or a healthy control group.
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Affiliation(s)
| | | | | | - Reda Badry
- Department of Neurology, Assiut University Hospitals, Assiut, Egypt
| | - Tarek A Rageh
- Department of Neurology, Assiut University Hospitals, Assiut, Egypt
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El Tallawy HN, Farghly WM, Badry R, Rageh TA, Shehata GA, Hakeem M NA, Abd El Hamed M, Sayd MAM, Hamed Y, Kandil MR. Prevalence of dementia in Al-Quseir city, Red Sea Governorate, Egypt. Clin Interv Aging 2013; 9:9-14. [PMID: 24353410 PMCID: PMC3862590 DOI: 10.2147/cia.s48325] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Dementia is one of the most important public health problems as a result of the rapid increase in the number of elderly persons worldwide. Improvement of prevention strategies and caring for people with dementia should be undertaken. We performed a door-to-door study to screen all subjects aged 50 years and older (n=4,329 of 33,285 inhabitants) in Al-Quseir city. The screening was performed by 3 neuropsychiatrists, using a modified form of the Mini-Mental State Examination. Suspected cases were subjected to case ascertainment according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, diagnostic criteria for dementia; full clinical assessment; psychometric assessment using Cognitive Abilities Screening Instruments, Hachinski Ischaemic Score, Instrumental Activities of Daily Living Scale and the Geriatric Depression Scale; neuroimaging (computed tomography and/or magnetic resonance imaging); and laboratory investigations for selected patients when indicated. The prevalence of dementia was 2.01% for participants aged 50 years or older and 3.83% for those aged 60 years or older. It increased steeply with increasing age to a maximum of 13.5% for those aged 80 years or older. Alzheimer's dementia (48.3%) was the most common subtype, followed by vascular dementia (36.8%), dementia resulting from general medical conditions (11.5%), and last, dementia resulting from multiple etiologies (3.4%).
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Affiliation(s)
| | | | - Reda Badry
- Department of Neurology, Assiut University, Assiut Egypt
| | - Tarek A Rageh
- Department of Neurology, Assiut University, Assiut Egypt
| | | | - N Abdel Hakeem M
- Department of Neurology Faculty of Medicine, Assiut University, Assiut Egypt
| | | | - Mohamed A M Sayd
- Department of Neurology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Yasser Hamed
- Department of Neurology Faculty of Medicine, Assiut University, Assiut Egypt
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Santos S, da Silva Pequeno AA, Pessoa A, Galvão CRC, de Medeiros JLA, Mathias W, Kok F. Increased prevalence of inherited neuromuscular disorders due to endogamy in Northeast Brazil: the need of community genetics services. J Community Genet 2013; 5:199-203. [PMID: 24277254 DOI: 10.1007/s12687-013-0174-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 11/04/2013] [Indexed: 10/26/2022] Open
Abstract
The aim of this study was to investigate the prevalence of inherited neuromuscular disorders (NMDs) in eight communities in Northeast (NE) Brazil in which there was an elevated rate of inbreeding. A cross-sectional epidemiological study, using the key informant (KI) approach, was performed to estimate the prevalence of NMD among the 48,499 individuals living in these eight communities, located in the backlands of the Paraíba State. Twenty-seven individuals fulfilled the diagnostic criteria for inherited NMD, which means that 1 out of 1,796 inhabitants of this highly consanguineous population was affected by NMD. This is twofold higher than that observed in previous studies in general population and was probably due to a combination of genetic drift and inbreeding. Public policies should be implemented to offer genetics services in high-risk communities.
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Affiliation(s)
- Silvana Santos
- Departamento de Biologia, Universidade Estadual da Paraíba, Rua Baraunas, 351, Campina Grande, PB, 58429-500, Brazil,
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Morales DR, Donnan PT, Daly F, Staa TV, Sullivan FM. Impact of clinical trial findings on Bell's palsy management in general practice in the UK 2001-2012: interrupted time series regression analysis. BMJ Open 2013; 3:e003121. [PMID: 23864211 PMCID: PMC3717449 DOI: 10.1136/bmjopen-2013-003121] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 06/07/2013] [Accepted: 06/17/2013] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To measure the incidence of Bell's palsy and determine the impact of clinical trial findings on Bell's palsy management in the UK. DESIGN Interrupted time series regression analysis and incidence measures. SETTING General practices in the UK contributing to the Clinical Practice Research Datalink (CPRD). PARTICIPANTS Patients ≥16 years with a diagnosis of Bell's palsy between 2001 and 2012. INTERVENTIONS (1) Publication of the 2004 Cochrane reviews of clinical trials on corticosteroids and antivirals for Bell's palsy, which made no clear recommendation on their use and (2) publication of the 2007 Scottish Bell's Palsy Study (SBPS), which made a clear recommendation that treatment with prednisolone alone improves chances for complete recovery. MAIN OUTCOME MEASURES Incidence of Bell's palsy per 100 000 person-years. Changes in the management of Bell's palsy with either prednisolone therapy, antiviral therapy, combination therapy (prednisolone with antiviral therapy) or untreated cases. RESULTS During the 12-year period, 14 460 cases of Bell's palsy were identified with an overall incidence of 37.7/100 000 person-years. The 2004 Cochrane reviews were associated with immediate falls in prednisolone therapy (-6.3% (-11.0 to -1.6)), rising trends in combination therapy (1.1% per quarter (0.5 to 1.7)) and falling trends for untreated cases (-0.8% per quarter (-1.4 to -0.3)). SBPS was associated with immediate increases in prednisolone therapy (5.1% (0.9 to 9.3)) and rising trends in prednisolone therapy (0.7% per quarter (0.4 to 1.2)); falling trends in combination therapy (-1.7% per quarter (-2.2 to -1.3)); and rising trends for untreated cases (1.2% per quarter (0.8 to 1.6)). Despite improvements, 44% still remain untreated. CONCLUSIONS SBPS was clearly associated with change in management, but a significant proportion of patients failed to receive effective treatment, which cannot be fully explained. Clarity and uncertainty in clinical trial recommendations may change clinical practice. However, better ways are needed to understand and circumvent barriers in implementing clinical trial findings.
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Affiliation(s)
- Daniel R Morales
- Division of Population Health Sciences, Medical Research Institute, University of Dundee, Dundee, UK
| | - Peter T Donnan
- Dundee Epidemiology and Biostatistics Unit, Population Health Sciences, Medical Research Institute, University of Dundee, Dundee, UK
| | - Fergus Daly
- Division of Population Health Sciences, Medical Research Institute, University of Dundee, Dundee, UK
| | - Tjeerd Van Staa
- Medicines and Healthcare products Regulatory Agency, London, UK
- Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
- London School of Hygiene & Tropical Medicine, London, UK
| | - Frank M Sullivan
- Division of Population Health Sciences, Medical Research Institute, University of Dundee, Dundee, UK
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El-Tallawy HN, Farghaly WM, Rageh TA, Shehata GA, Abdel Hakeem M N, Badry R, Kandil MR. Prevalence of trigeminal neuralgia in Al-Quseir city (Red sea Governorate), Egypt. Clin Neurol Neurosurg 2013; 115:1792-4. [PMID: 23692870 DOI: 10.1016/j.clineuro.2013.04.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 04/15/2013] [Accepted: 04/22/2013] [Indexed: 11/15/2022]
Abstract
BACKGROUND Trigeminal neuralgia or tic douloureux is sometimes described as the most excruciating pain known to humanity. OBJECTIVES To estimate the prevalence of trigeminal neuralgia among the population of Al-Quseir city. METHODS This study forms a part of door to door survey of major neurological disorders in Al-Quseir city, Red sea governorate, Egypt. The total population (33,285 persons) were screened through door to door (every door) by three specialists of Neurology and fifteen female social workers. Then, positive cases were subjected to clinical and neurological examination by other three staff members of neurology. Cases were identified as suffering from trigeminal neuralgia according to the diagnostic criteria of the International headache society (IHS). RESULTS We identified 4 female patients out of 13,541 persons (aged 30 years and more) suffering from trigeminal neuralgia with age specific prevalence rate of 29.5/100,000. Co-morbid depression and hypertension were observed among the affected persons.
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George-Carey R, Adeloye D, Chan KY, Paul A, Kolčić I, Campbell H, Rudan I. An estimate of the prevalence of dementia in Africa: A systematic analysis. J Glob Health 2013; 2:020401. [PMID: 23289076 PMCID: PMC3529309 DOI: 10.7189/jogh.02.020401] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background The burden of non–communicable diseases is growing, particularly in developing countries. The greatest economic burden is due to dementia, the prevalence of which is rising with increasing longevity. In Africa, where the rate of increase of elderly persons is the fastest in the world, dementia is normally dismissed as a part of normal ageing. The lack of awareness means that many patients are suffering undiagnosed. This review aims to assess the information on the prevalence of dementia in Africa in order to estimate the current burden. Methods A parallel search of Medline, EMBASE and Global Health limited to post–1980 found only 10 relevant studies. Data on prevalence and risk factors were extracted and analysed. We modelled the available information and used the UN population figures for Africa to determine the age–specific and overall burden of dementia. Results The overall prevalence of dementia in adults older than 50 years in Africa was estimated to be about 2.4%, which translates to 2.76 million people living with a disease in 2010. About 2.10 millions of them live in Sub–Saharan Africa. Prevalence was the highest among females aged 80 and over (19.7%) and there was little variation between regions. Alzheimer disease was the most prevalent cause of dementia (57.1%) followed by vascular dementia (26.9%). The main risk factors were increasing age, female sex and cardiovascular disease. Conclusions Information on dementia prevalence in Africa is very limited. Further research will not only provide a more reliable estimate of prevalence, and consequently the burden of disease, but will also raise awareness of the problem. This is critical in promoting help–seeking behaviour and generating the political commitment to make dementia a public health priority in Africa.
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Affiliation(s)
- Rhiannon George-Carey
- Centre for Population Health Sciences, University of Edinburgh Medical School, Edinburgh, Scotland, UK
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El-Tallawy HN, Farghaly WM, Shehata GA, Rageh TA, Hakeem NMA, Hamed MAA, Badry R. Prevalence of Parkinson's disease and other types of Parkinsonism in Al Kharga district, Egypt. Neuropsychiatr Dis Treat 2013; 9:1821-6. [PMID: 24379673 PMCID: PMC3843639 DOI: 10.2147/ndt.s48318] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Parkinson's disease (PD) is a common neurodegenerative disorder in older people. The prevalence of PD varies among ethnic and geographic groups around the world. In this study, we aimed to estimate the prevalence of PD and other types of Parkinsonism in persons aged ≥40 years in the Al Kharga district of Egypt. The study was conducted on the total population of Al Kharga district (62,583 persons) between 2005 and 2009 and involved three neurology specialists and 15 female social workers undertaking a door-to-door survey. Suspected cases of Parkinsonism were subjected to meticulous clinical and neurological examination by three neurology staff members from Assiut University hospital who carried out their examinations separately. Of the total population surveyed, 15,482 persons were aged ≥40 years and 49 of these were identified as having Parkinsonism (prevalence: 316.50 per 100,000 people [95% confidence interval {CI} 240.21-404.98]). Of the 49, 33 fulfilled the diagnostic criteria for PD, giving a prevalence rate of 213.15/100,000 (95% CI 150.51-285.80) while 14 fulfilled those for vascular Parkinsonism, with a prevalence rate of 90.43/100,000 (95% CI 49.60-137.78). Postencephalitic and unspecified Parkinsonism each had a prevalence rate of 6.46/100,000. The prevalence of Parkinsonism was found to increase steadily with age, and the prevalence of all types of Parkinsonism was statistically higher in rural compared with urban communities, with no significant difference between men and women.
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Affiliation(s)
| | | | | | - Tarek A Rageh
- Department of Neurology, Assiut University, Assiut, Egypt
| | | | | | - Reda Badry
- Department of Neurology, Assiut University, Assiut, Egypt
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El Tallawy HN, Farghly WM, Badry R, Rageh TA, Hakeem Metwally NA, Shehata GA, Sayd MA, Hamed Y, Kandil MR. Prevalence of Spinal Cord Disorders in Al-Quseir City, Red Sea Governorate, Egypt. Neuroepidemiology 2013; 41:42-7. [DOI: 10.1159/000348320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Accepted: 01/09/2013] [Indexed: 11/19/2022] Open
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Farghaly WM, El-Tallawy HN, Shehata GA, Rageh TA, Abdel-Hakeem NM, Elhamed MAA, Al-Fawal BM, Badry R. Epidemiology of nonfatal stroke and transient ischemic attack in Al-Kharga District, New Valley, Egypt. Neuropsychiatr Dis Treat 2013; 9:1785-90. [PMID: 24273409 PMCID: PMC3836687 DOI: 10.2147/ndt.s48322] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Stroke is a medical emergency. Nonfatal stroke may cause permanent neurologic damage, complications, and disability. The aim of this study was to determine the epidemiology of nonfatal stroke in Al-Kharga District, New Valley, Egypt. METHODS The total population (62,583) was screened via a door-to-door study by three neurology specialists and 15 female social workers for demographic data collection. All subjects with probable stroke were subjected to a full clinical examination, neuroimaging (computed tomography and/or magnetic resonance imaging of the brain), and laboratory investigations including blood sugar, lipid profile, serum uric acid, a complete blood count, blood urea, and serum creatinine. Stroke severity and outcome were assessed using the Scandinavian Stroke Scale and Barthel Index. Carotid Doppler, echocardiography, and thyroid function tests were done in selected cases. RESULTS During the study period (June 1, 2005 to May 31, 2008), 351 subjects were diagnosed as having suffered a cerebrovascular stroke at some point during their lives, yielding a total lifetime prevalence of 5.6 per 1,000 population. Of these, 156 subjects were identified as having suffered a stroke during the year from January 1 to December 31, 2007, with an incidence rate of 2.5 per 1,000. Both prevalence and incidence rates were higher in urban (5.8 per 1,000 and 2.6 per 1,000, respectively) than rural communities (5.2 per 1,000 and 2.3 per 1,000), and were higher in males (6.1 per 1,000 and 2.7 per 1,000, respectively) than in females (5.1 per 1,000 and 2.3 per 1,000). Thrombotic stroke had the highest prevalence and incidence rates (4.2 per 1,000 and 1.7 per 1,000, respectively), whereas subarachnoid hemorrhage had the lowest prevalence and incidence rates (0.03 per 1,000 and 0.02 per 1,000). CONCLUSION The prevalence of cerebrovascular accident in Al-Kharga lies in the lower range of that in developing countries, and is similar to that in industrialized countries.
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Affiliation(s)
- Wafaa Ma Farghaly
- Department of Neurology, Faculty of Medicine, Assiut University, Assiut, Egypt
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Tallawy HNE, Farghaly WM, Rageh TA, Shehata GA, Badry R, Metwally NA, Moselhy EAE, Hassan M, Sayed MA, Waris AA, Hamed Y, Shaaban I, Hamed MA, Kandil MR. Door-to-door survey of major neurological disorders (project) in Al Quseir City, Red Sea Governorate, Egypt. Neuropsychiatr Dis Treat 2013; 9:767-71. [PMID: 23745047 PMCID: PMC3671800 DOI: 10.2147/ndt.s36956] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
A door-to-door survey, including every household, was conducted for all inhabitants of Al Quseir City (33,283), Red Sea Governorate, Egypt by three specialists of neurology as well as nine senior staff members of neurology and 15 female social workers to assess the epidemiology of major neurological disorders. Over six phases, from July 1, 2009 to January 31, 2012, screening of all eligible people in the population was carried out, by which case ascertainment of all major neurological disorders included in the study was done according to the accepted definitions and diagnostic criteria of the World Health Organization. The order of frequency of prevalence of the studied neurological disorders was dementia (3.83% for those aged > 60 years), migraine (2.8% for those aged > 8 years), stroke (6.2/1000 for those aged > 20 years), epilepsy (5.5/1000), Parkinson's disease (452.1/100,000 for those aged > 40 years), cerebral palsy (3.6/1000 among children < 18 years), spinal cord disorders (63/100,000) dystonia (39.11/100,000), cerebellar ataxia (30.01/100,000), trigeminal neuralgia (28/100,000 for those aged > 37 years), chorea (21.03/100,000), athetosis (15/100,000), and multiple sclerosis (13.74/100,000). The incidence rates of stroke, epilepsy, and Bell's palsy were 181/100,000, 48/100,000, and 98.9/100,000 per year, respectively.
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Affiliation(s)
- Hamdy Na El Tallawy
- Department of Neurology, Faculty of Medicine, Assiut University, Assiut, Egypt
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Habeych ME, García-Habeych JM, Castilla-Puentes RC. Different neurological conditions between urban and rural samples from central Colombia. J Neurol Sci 2012; 320:56-60. [PMID: 22831764 DOI: 10.1016/j.jns.2012.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 05/25/2012] [Accepted: 06/23/2012] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Despite availability of neuroepidemiological data, urban-rural differences on neurological diseases have almost never been considered. Our goal is to identify differences in the frequency of neurological conditions between a rural and an urban sample from central Colombia. METHODS We compared frequencies of neurological encounters of an urban sample from Bogotá (N=2932), to our rural sample from Tunja (N=2664), collected both circa to 2000. The classification of neurological conditions used is based on the 9th revision of the International Classification of Diseases, clinical modification. A clustered sampling was used. Information collection was performed in a format designed for this purpose and already used in Colombia. RESULTS Highly significant statistical differences (p<0.0001) were found for cerebrovascular diseases, seizure disorder, headache, Parkinson's disease and other movement disorders, and, inflammatory (infectious) conditions. Neurodevelopmental disorders (p=0.0029), dizziness and balance problems (p=0.0018), and neuropathies (p=0.0007), also showed statistically significant differences. CONCLUSIONS Our study showed significant differences on all categories and diagnostics between the samples. Cerebrovascular disease the most frequent reason of neurological consultation in the rural sample could be confounded by sociodemographic (aging of the population, urbanization process), or the concomitant presence of medical (chronic pulmonary) and/or environmental (air pollution) conditions.
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Affiliation(s)
- Miguel E Habeych
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
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El Tallawy HN, Farghly WMA, Shehata GA, Rageh TA, Hakeem NA, Abo-Elfetoh N, Hegazy AM, Rayan I, El-Moselhy EA. Prevalence of dementia in Al Kharga District, New Valley Governorate, Egypt. Neuroepidemiology 2012; 38:130-7. [PMID: 22433971 DOI: 10.1159/000335655] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Accepted: 12/05/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND With aging, there is a parallel increase in the prevalence of dementia worldwide. The aim of this work is to determine the prevalence of dementia among the population of Al Kharga District, New Valley, Egypt. METHODS Screening of all subjects aged ≥50 years (n = 8,173 out of 62,583 inhabitants) was done through a door-to-door survey by 3 neurologists, using a short standardized Arabic screening test and a modified Mini-Mental State Examination. Suspected cases were subjected to full clinical examination, psychometric assessment using the Cognitive Abilities Screening Instrument, Instrumental Activities of Daily Living Scale, Geriatric Depression Scale, Hachinski Ischemic Score, DSM-IV-TR diagnostic criteria, neuroimaging, and laboratory investigations, when indicated. RESULTS The prevalence rate of dementia was 2.26% for the population aged ≥50 years. It increased steeply with age to a maximum of 18.48% for those aged ≥80 years. Alzheimer's disease (51.2%) was the most common subtype, followed by vascular dementia (28.7%), dementia due to general medical conditions (12.8%), and lastly dementia due to multiple etiologies (7.3%). Mild dementia was the commonest (53.7%). CONCLUSION Dementia is prevalent in Egypt as elsewhere. Detection through a door-to-door survey is the best method in developing countries for early detection of mild cases.
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Affiliation(s)
- Hamdy N El Tallawy
- Department of Neurology, Faculty of Medicine, Assiut University, Assiut, Egypt
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Quet F, Preux PM, Huerta M, Ramirez R, Abad T, Fragoso G, Morales J, Sciutto E, Fleury A. Determining the burden of neurological disorders in populations living in tropical areas: who would be questioned? Lessons from a Mexican rural community. Neuroepidemiology 2011; 36:194-203. [PMID: 21606653 DOI: 10.1159/000327496] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Accepted: 03/07/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The best approach to determine the burden of neurological disorders in developing countries is to perform population-based studies. Our objectives were to determine the prevalence of neurological disorders in a Mexican rural community and assess the usefulness of a household screening questionnaire. METHODS The survey took place in a Mexican rural community of Puebla State in Mexico. This was a cross-sectional, population-based, 2-phase study including a comparison of the usefulness levels of the individual (IQ) and household (HQ) questionnaires. RESULTS A total of 4,008 individuals participated in the prevalence study using the IQ; of these, 280 neurological examinations allowed to identify 127 individuals suffering from at least 1 neurological disease. The most frequent ailments were headache (22.4/1,000, 95% confidence interval, CI: 17.7-28.2), neuropathy (7.1/1,000, CI 95%: 4.4-11.3) and epilepsy (3.9/1,000, CI 95%: 2.3-6.5). The HQ, used in parallel with the IQ, detected significantly fewer neurological cases. This result was mainly due to the low capacity of the HQ to detect headache. CONCLUSIONS Results of the prevalence study are discussed emphasizing their relevance in adequately allocating resources. The usefulness of the HQ for screening neurological disorders in general was low, but could be adequate for specific neurological disorders.
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Affiliation(s)
- Fabrice Quet
- IFR 145 GEIST, Institut d'Epidémiologie Neurologique et de Neurologie Tropicale, EA 3174 Neuroepidémiologie Tropicale et Comparée, Université de Limoges, Limoges, France
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