Determining the Burden of Neurological Disorders in Populations Living in Tropical Areas: Who Would Be Questioned? Lessons from a Mexican Rural Community

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.

Stroke survivors in Nigeria: A door-to-door prevalence survey from the Niger Delta region

“…Initial attempt to unravel the prevalence of stroke in a rural community of Niger Delta in 2014 reported a prevalence of 8.51/1000 [4]. This rate is about 6-fold higher compared to other regions in Nigeria and more than the rates found in most urban and rural populations in LMICs particularly in Africa and South America [7], [16], [17], [18], [19] and [20]. Despite the increased morbidity occasioned by shortage of neurological care and prohibitive out-of-pocket cost for quality care, health policy target has not recognised the enormity of the problem.…”

CYP2C9, CYP2C19, ABCB1 genetic polymorphisms and phenytoin plasma concentrations in Mexican-Mestizo patients with epilepsy

“…1 In Mexico, epilepsy affects approximately 1.5-2 million individuals, 2 most of them younger than 40 years of age. 3 Consequently, epilepsy is the primary cause of outpatient visits at the National Institute of Neurology and Neurosurgery Manuel Velasco Suárez (INNN) in Mexico City, and phenytoin (PHT) is one of the three most prescribed antiepileptic drugs at this hospital. 4 PHT has a narrow therapeutic index (10-20 μg ml − 1 ) and nonlinear pharmacokinetics with a wide inter-individual variability in clearance, making therapeutic drug monitoring an important adjunct to the treatment of epilepsy.…”

Different neurological conditions between urban and rural samples from central Colombia

“…Indeed, neuro-epidemiological surveys carried out in developing countries from around the world, such as Nigeria [21], Saudi Arabia [22], Mexico [23], Egypt [24], Ecuador [25], and even Colombia [26], usually do not emphasize the different rural-urban frequencies of neurological conditions. Thus, information about the urban or rural profiles of disorders obtained from neurology services of tertiary care hospitals from these areas, is valuable [27].…”