Prevalence of neuroinfectious diseases and outcomes in Africa

Abstract

Neuroinfectious diseases are infections affecting the central and peripheral nervous system, possibly due to bacterial, viral, fungal, or parasitic infections [1] . The route of infection to the nervous system could be through direct inoculation, blood circulation, retrograde spread, or others [2] . Central nervous system infections are often challenging to diagnose, and the burden of undiagnosed nervous system infections is currently underreported; despite the recent advances in investigative technology, about 30% of patients with suspected central nervous system infections never received an etiological diagnosis, with nearly one-third of these patients dying of the illness [3,4] . Neurological disorders related to neuroinfectious diseases are highly prevalent in sub-Saharan Africa, which constitute a significant cause of disabilities and economic burden for the patients and society [5] . There are dual burdens of neuroinfectious diseases in developing countries of Africa in which the conditions are both under-recognized and under-treated [6] . One of the significant challenges of neuroinfectious diseases in Africa is the lack of neurological experts, with the average number of neurologists to the general population of about 1-3.4 million in some African countries; with about 11 countries not having any neurologists, the case is worst in neurological surgery [6,7] .

Frailty concept in Africa neurosurgical practice: a prospective review

“…One or two of these features indicate a precursor state, three or more of these features indicate frailty, and none indicate no frailty [7]. Frailty is a concept that has been used to determine surgical outcomes in older patients; therefore, it becomes a crucial factor in Africa's practice of neurological surgery, as a result of increased life expectancy in the continent and increase usage of neurosurgical services [8][9][10][11] With expanding population of elderly people in the world and Africa, improving neurosurgical care to this age group becomes paramount, and frailty studies are important tools in ensuring improved neurosurgical service delivery to elderly people in Africa. Wojda et al reported an increase in the population of elderly patient that are presenting in the accident and emergencies in sub-Saharan Africa over the period of 1989-2014, as seen in Fig.…”