Epidemiology of neurodegenerative diseases in sub-Saharan Africa: a systematic review

BMC Public Health

Andre P Kengne³  Justin B Echouffo-Tcheugui¹  Alain Lekoubou² 

[1] MedStar Health, Baltimore, Maryland, USA;Department of Neurosciences, Division of Neurology, Medical University of South Carolina, Charleston, USA;Non-Communicable Diseases Research Unit, South African Medical Research Council, PO Box 19070 Tygerberg, Cape Town 7505, South Africa

关键词: Sub-Saharan Africa;    HIV-related cognitive impairment;    Dementia;    Parkinsonism;    Neurodegenerative diseases;   

Others  :  1131383
DOI  :  10.1186/1471-2458-14-653

 received in 2013-09-09, accepted in 2014-05-19,  发布年份 2014

【 摘 要 】

Background

Sub-Saharan African (SSA) countries are experiencing rapid transitions with increased life expectancy. As a result the burden of age-related conditions such as neurodegenerative diseases might be increasing. We conducted a systematic review of published studies on common neurodegenerative diseases, and HIV-related neurocognitive impairment in SSA, in order to identify research gaps and inform prevention and control solutions.

Methods

We searched MEDLINE via PubMed, ‘Banque de Données de Santé Publique’ and the database of the ‘Institut d’Epidemiologie Neurologique et de Neurologie Tropicale’ from inception to February 2013 for published original studies from SSA on neurodegenerative diseases and HIV-related neurocognitive impairment. Screening and data extraction were conducted by two investigators. Bibliographies and citations of eligible studies were investigated.

Results

In all 144 publications reporting on dementia (n = 49 publications, mainly Alzheimer disease), Parkinsonism (PD, n = 20), HIV-related neurocognitive impairment (n = 47), Huntington disease (HD, n = 19), amyotrophic lateral sclerosis (ALS, n = 15), cerebellar degeneration (n = 4) and Lewy body dementia (n = 1). Of these studies, largely based on prevalent cases from retrospective data on urban populations, half originated from Nigeria and South Africa. The prevalence of dementia (Alzheimer disease) varied between <1% and 10.1% (0.7% and 5.6%) in population-based studies and from <1% to 47.8% in hospital-based studies. Incidence of dementia (Alzheimer disease) ranged from 8.7 to 21.8/1000/year (9.5 to 11.1), and major risk factors were advanced age and female sex. HIV-related neurocognitive impairment’s prevalence (all from hospital-based studies) ranged from <1% to 80%. Population-based prevalence of PD and ALS varied from 10 to 235/100,000, and from 5 to 15/100,000 respectively while that for Huntington disease was 3.5/100,000. Equivalent figures for hospital based studies were the following: PD (0.41 to 7.2%), ALS (0.2 to 8.0/1000), and HD (0.2/100,000 to 46.0/100,000).

Conclusions

The body of literature on neurodegenerative disorders in SSA is large with regard to dementia and HIV-related neurocognitive disorders but limited for other neurodegenerative disorders. Shortcomings include few population-based studies, heterogeneous diagnostic criteria and uneven representation of countries on the continent. There are important knowledge gaps that need urgent action, in order to prepare the sub-continent for the anticipated local surge in neurodegenerative diseases.

【 授权许可】

   
2014 Lekoubou et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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