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The prevalence of neurological disorders, including those of a palliative nature, in people aged 70 years and over in the Hai district of northern Tanzania
  1. F. Dewhurst1,4,
  2. M. J. Dewhurst1,4,
  3. W. K. Gray1,
  4. W. Howlett2,
  5. N. Warren3,
  6. G. Orega2 and
  7. R. W. Walker1,4
  1. 1Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
  2. 2Kilimanjaro Christian Medical Centre, Moshi, Tanzania
  3. 3Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle-upon-Tyne
  4. 4Institute of Health and Society, Newcastle University, Newcastle upon Tyne


Introduction There are few data on neurological disorder prevalence from developing countries, particularly sub-Saharan Africa (SSA), and none specific to the elderly despite a need highlighted by the World Health Organisation.

Aims and Methods We determined the prevalence of neurological disorders in those aged 70 years and over in a rural African community, described their sub-groups including those of a palliative nature, level of diagnosis and treatment and associated disability. We carried out an epidemiological survey in the Hai district demographic surveillance site (DSS) in northern Tanzania (n=161,119). 2232 participants (1/4 of the DSS 70+ population) were screened with a validated screening questionnaire with high sensitivity (87.8%) and specificity (94.9%). Positive responders underwent full neurological assessment to confirm or refute the presence of a neurological diagnosis.

Results In 2232 participants, there were 384 neurological diagnoses amongst 349 people. The age adjusted prevalence (cases/1000 population) of neurological diagnoses (95% confidence intervals (CI)) was 168.9/1000 (153.4 to 184.5). Palliative neurological disorders included Parkinson's disease, progressive supra-nuclear palsy and motor neuron disease. 14.6% had been correctly diagnosed and 10.6% were on appropriate treatment. Neurological disorders were associated with disability.

Conclusion This is the first community-based neurological disorder prevalence study specifically in the elderly in SSA. It reveals a high prevalence of neurological morbidity, low diagnosis and treatment levels and high associated disability and demonstrates the contribution neurological morbidity makes to the non-communicable disease epidemic.

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