Profil épidémiologique des maladies et syndromes neurodégénératifs: étude hospitalière rétrospective et multicentrique sur 15 ans à Yaoundé et Douala

Alida Estelle BOBDA NGNE (ngnealida@yahoo.fr)
Médecine interne, Université de Yaoundé I
July, 2015
 

Abstract

Background: World population is ageing and Sub-Saharan African countries are experiencing an increase in life expectancy. As a result, age related conditions such as neurodegenerative diseases may increase. The estimated prevalence of neurodegenerative diseases was 3.9% in a hospital-based study over a 9-year period ranging from 1993-2001. No further studies have been carried out on the epidemiological features of these diseases in our country.

Objectives: This study was aimed at determining the global prevalence and proportion of each type of neuro-degenerative disease, assessing comorbidities and associated factors and finally assessing the diagnosis period of each type.

Methods: A cross sectional, retrospective descriptive and analytic study over a 15-year period from 2000-2014 in the neurological in and out-patients department of the Yaounde Central Hospital and the Douala General Hospital was carried out. Medical files of patients served as basis for our recruitment. File with four major diagnoses (Parkinsonism, chorea, amyotrophic lateral sclerosis and dementia), made by neurologists were included. Epidemiological, clinical and paraclinical data were recorded for each patient.

Results: A total of 54825 new patients were enrolled in both hospitals over the study period. Among them, 161 were diagnosed with dementia, 200 with parkinsonism, 23 with amyotrophic lateral sclerosis, 14 with chorea, 7 with both dementia and parkinsonism and 1 with both chorea and dementia.
The prevalence of neurodegenerative diseases was 0.74%. Pakinsonism, dementia, amyotrophic lateral sclerosis and chorea accounted for 51%, 41.6%, 5.7% and 3.7% respectively. High blood pressure, diabetes, family history of neurodegenerative diseases and age were readily the major factors associated with neurodegenerative diseases. Comorbidities such as high blood pressure, diabetes, tobacco consumption, history of stroke were the most common. The frequency of comorbidities was higher in patients with dementia or parkinsonism as compared with the other groups.
The mean of diagnosis period varied from 20.5 to 41.1 months. The lowest diagnosis period observed was that for dementia and the highest that for amyotrohic lateral sclerosis.

Conclusion: Neurodegenerative diseases are present in Yaounde and Douala. Parkinsonism and dementias are more represented. Comorbidities are frequent in patients with degenerative brain diseases. Associated factors include high blood pressure and diabetes. The disease begins relatively earlier than in other populations. The diagnosis is made after a long period during the course of the disease. The appropriate diagnosis may be compromised by the cost of diagnostic facilities and the lack of qualified personnel.

Key words: Epidemiology; Neurodegenerative diseases; Parkinsonism; Chorea; Amyotrophic lateral sclerosis; Yaoundé; Douala.


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