Addressing the Burden, High Treatment Gap and Societal Impact of Neurological Disorders in Nigeria: The Results of a Neuro-Epidemiological Survey in a Rural Riverine Community of Southwest Nigeria
Asian Journal of Research and Reports in Neurology,
Background: Over the last few years, there has been a steady increase in the incidence of neurological diseases in Nigeria particularly stroke, epilepsy and dementia. Therefore, it was needful to determine the current burden imposed by such disorders in Nigeria especially in the rural communities. This survey was carried out in Ilie community, Southwest Nigeria. The aim of this report is to address some of the findings of the survey including the high treatment gap, social issues and societal impact of these common neurological disorders on the community.
Methods: The study was carried out in a remote community known as Ilie which is located in Osun state, Nigeria. Ilie ward was screened from door to door, to identify people who had suffered from Neurological Disorders (ND) (lifetime prevalence).In determining the prevalence of ND, a two-phase cross-sectional study design was adopted. The first phase involved the demographic data collection from each screened household and the administration of WHO screening questionnaire for ND by the trained field interviewers. The second phase was the clinical examination of the participants who were positivenduring the first phase of screening by the neurologists to confirm the diagnosis of the identified neurological disease. Social issues such as access to education, employment opportunities and marital prospects as well as treatment issues were also assessed.
Results: In the first phase, the numbers of individuals screened were 2212, all from 231 households. The female participants accounted for 1111(50.3%) and males were 1101(49.7%), therefore the females were slightly more than the males. Thirty-three (33) cases of ND were detected giving a point prevalence of 1.9% and epilepsy was discovered to be the commonest. Traditional medicine as well as spiritual healing was the mainstay of treatment.
Conclusions: The burden of neurological disease was still high in this rural community of Southwest Nigeria and knowledge, social and treatment issues were still present.
- neurological disorders
- knowledge and treatment
How to Cite
World Health organization; Neurological disorders, public health challenges. Geneva, World Health Organization; 2006.
Bergen DC, World Federation of Neurology Task force on neurological services; Training and distribution of Neurologists worldwide. J Neurol. Sci. 2002;198:3-7
World Health Organization: Atlas; country resources for neurological disorders 2004: Results of a collaborative study of the World Health Organization and The World Federation of Neurology. World Health Organisation; 2004.
Quet F, Odermatt P, Preux PM: Challenges of epidemiological research on epilepsy in resource- poor countries. Neuroepidemiology. 2008;30:3-5
Osuntokun BO, Adeuja A, Schoenberg BS, Bademosi O, Nottidge VA, Olumide AO, Ige O, Yaria F, Bolis CL: Neurological disorders in Nigerian – Africans; A community based study. Acta Neurol !987;75:13-21
Owolabi MO, Bower JH, Ogunniyi A. mapping Africa‘s way into prominence in the field of neurology. Arch Neurol. 2007;64:1696-1700.
World Health Organization: WHO protocol: Epidemiologic studies of neurologic disorders. Geneva world health Organization, 1981.
Kaddumu kasa M, Mugenyi L, Kaddumukasa MN, Ddumba E et al . prevalence and incidence of neurological disorders among Adult Ugandans in rural and urban Mukano district, a cross sectional study. BMC Neurology. 2016;16:227.
Mustapha AF, Preux PM, Sanya EO, Akinleye CA. The prevalence and subjective handicap of Epilepsy in - A rural riverine community in south west Nigeria: A door- to – door survey. Epilepsy and Behavior. 2014;37:258-264.
World Health Organization. Neurological Disorders: Public Health Challenges. Geneva, Switzerland: World Health Organization; 2006.
GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015.Lancet. 2016;38:1545–1602.
Oluwole OG, Kuivaniem, CarrJA, Ross OA, Olaogun MB, Bardien S, Komolafe MA. Parkinson’s disease in Nigeria:A review of published studies and recommendations for future research. Parkinsonism Relat. Disord. 2019;62:841-845
Schoenberg BS, Anderson DW, Haerer AF. Prevalence of Parkinson’s disease in the biracial population of Copiah county Mississippi. Neurology. 1985;35(6):36-43
Iloeje SO. Febrile convulsions in a rural and an urban population. East Afr Med J. 1991;68:43–51
Rwiza HT, Kilonzo GP, Haule J, Matauja WBP, Mteza I, Mbena P, et al. Prevalence and incidence of epilepsy in Ulanga, a rural Tanzanian district: A community based study. Epilepsia. 1992;33:1051-1056
Yusuf AJ, Baiyewu O, Sheikh TL, Shehu AU. Prevalence of dementia and dementia subtypes among community-dwelling elderly people in northern Nigeria. Int Psychogeriatr. 2011;23(3): 379-386
Ogunniyi A1, Baiyewu O, Gureje O, Hall KS, Unverzagt F, Siu SH, Gao S, Farlow M, Oluwole OS, Komolafe O, Hendrie HC. Epidemiology of dementia in Nigeria: results from the Indianapolis-Ibadan study.Eur J Neurol. 2000;7(5):485- 90.
Schneider J, Murray J, Banerjee S, Mann A. EUROCARE: A cross-national study of co-resident spouse carers for people with Alzheimer's disease: I—factors associated with carer burden. Int J Geriatr Psychiatry. 1999;14:651–661.
10/66 Dementia Research Group Care arrangements for people with dementia in developing countries. Int J Geriatr Psychiatry. 2004;19:170–177.
Global prevalence of Dementia: a Delphi Consensus study. Lancet Dec. 2005;366(9503):2112-2117.
Lv Y, Tian W, Chen D, Liu Y, Wang L, Duan F. The prevalence and associated factors of symptomatic cervical Spondylosis in Chinese adults: a community-based cross-sectional study. BMC musculoskeletal disorders. 2018;19(1):325.
Sanya EO, Desalu OO, Adepoju F, Aderibigbe SA, Shittu A, Olaosebikan O. Prevalence of stroke in three semi-urban communities in middle-belt region of Nigeria: a door to door survey. Pan African Medical Journal. 2015;20:33- 39.
Osuntokun BO. Stroke in the Africans. African Journal of Medicine & Sciences. 1977;6(2):39-52.
Kelechi O. Enwereji et al. Epidemiology of stroke in a rural community in Southeastern Nigeria.Vasc Health Risk Manag. 2014;10:375–388.
Onwuchekwa AC, Tobin-west C, Babatunde S. Prevalence and risk factors for stroke in adult population in a rural community in the Niger Delta, South-South Nigeria. J Stroke cerebrovascular Dis. 2014;23(3):505-510.
Danesi M, Okubadejo N, Ojini F. Prevalence of stroke in an urban, mixed-income community in Lagos Nigeria. Neuroepidemiology. 2007;28(4):216-223.
Okubadejo et al.: Prevalence of essential tremor inurban Lagos, Nigeria: a door-to-door community-based study. BMC Neurology. 2012;12:110.
Woldeamanuel YW, Girma B. Contributing Towards the betterment of Translational Epilepsy Research in Africa: Needs, Challenges, Resources and opportunities. Curr .Neurol Neurosci. Rep. 2014;14:470
Danesi MA, Adetunji JB. Use of alternative medicine by patients with epilepsy: A survey of 265 epileptic patients in a developing country. Epilepsia. 1994:35(2)344-351
Kabir M, Ilyasu Z, Abubakar IS, Farinyaro AU. Knowledge, attitude and beliefs about epilepsy among adults in a Northern Nigeria Urban community. Ann. Afr. Med. 2005;4(3):107-112
World Health Organization, international Bureau of epilepsy. Atlas; Epilepsy Care in the world 2005. Geneva. World Health organization, 2005;76-77.
The World Bank. Poverty Data; a supplement to world development indicators 2008. Washington; International Bank for reconstruction and Development/ the World Bank 2008.
Chabot J. the Bamako initiative (letter).Lancet. 1998;2(8624):1366-1367
Awaritefe A, Longe AC, Awaritefe M. epilepsy and psychosis: A Comparison of societal attitudes. Epilepsia 1985;26(1):1-9
Awaritefe A. epilepsy: the myth of a contagious disease: Cult med. Psychiatry 1989;13(4):446-456
Sanya EO, Salami TA, Goodman OO, Buhari O.I Araoye M.O. perception and attitudes to epilepsy amongst teachers in primary, secondary and tertiary educational institutions in middle- belt Nigeria. Trop. Doct 2005;35(3):153-156
Aikor EA, Essien AA. Childhood epilepsy knowledge and attitude of primary school teachers in Port Harcourt Nigeria. Niger J. med 2005;14(3):299-303.
Adamolekun B, Mielke JK, Ball D.E. An evaluation of the impact of health worker and patient education and the care and compliance of patient with epilepsy in Zimbabwe. Epilepsia. 1999; 40:507-511.
Carpio A, Bharucha NE, Jallon P. Beghi E, Campostrini R, Zorzetto S , et al. Mortality of epilepsy in developing countries. Epilepsia. 2005;46(SII):28-32.
Birbeck AL, Kalichi EMN. Epilepsy prevalence in rural Zambia; A door – to – door survey. Trop Med Intl Health. 2004;9:92-95
World Health Organization. Epilepsy in the WHO Africa region bridging the gap. Geneva; WHO: 2004.
Scott RA, Lhatto SD, Sander JWAS. Policy and practice – the treatment of epilepsy in developing countries; where do we go from here? Bulletin World Health Organization. 2011; 79:344-351.
World Health Organization; Atlas: Epilepsy care in the world. Geneva: WHO;2005
KamgnoJ, Pion SD, Boussinesq M. Demographic impact of epilepsy in Africa: Results of a 10-year cohort study in a rural area of Cameroon. Epilepsia. 2003;44:956-963.
Nsengiyumva G, Druet – Cabanac M, Nzisabira L, Preux PM, Vergnenegre A. Economic Evaluation of Epilepsy in Kiremba (Burundi): a Case - control- study. Epilepsia. 2004;45:673- 677.
Abstract View: 34 times
PDF Download: 65 times