The spectrum of neurological disorders in a Zambian tertiary care hospital.
OBJECTIVE
To define the spectrum of inpatient and outpatient neurological illness in a Zambian tertiary care facility where HIV is endemic.


METHODS
A retrospective period prevalence study of patients seen by the consulting neurologist between 1/2/06-12/20/06 at the University of Zambia's University Teaching Hospital (UTH).


RESULTS
443 inpatients and 368 outpatients were seen during this period. Overall, 160 (19.7%) patients underwent HIV testing: 125 (15.4%) HIV(+) and 35 (4.3%) HIV(-). The other 651 (80.3%) patients were untested. The most common inpatient neurological diseases among HIV(+) patients were infectious diseases 26 (38.8%), neuropathy/radiculopathy 10 (10.4%), cerebrovascular disease 6 (9.0%), and myelopathy 5 (7.5%). The most common inpatient neurological diseases in the general population were cerebrovascular disease 62 (16.5%), infectious diseases 47 (12.5%), neuropathy/radiculopathy 37 (9.8%), and seizures/epilepsy 27 (7.2%). In the outpatient population, the most common neurological illnesses in HIV(+) patients were neuropathy/radiculopathy 18 (31.0%), cerebrovascular disease 8 (13.8%), dementia/neurodegenerative 8 (13.8%), and encephalopathy 7 (12.1%). Outpatients in the general population most commonly had headaches/cephalgias 60 (19.4%), movement disorders 47 (15.2%), neuropathy/radiculopathy 43 (13.8%), and seizures/epilepsy 39 (12.6%).


CONCLUSIONS
HIV-infected individuals are a sizeable group among neurology patients in Zambia, and they are affected by a different disease spectrum than the general population. Infectious diseases make up the largest percentage of inpatient neurological illness. Non-infectious causes are responsible for the majority of outpatient neurological cases. Emphasis should be placed on treatment of both infectious and non-infectious neurological illnesses. The most common outpatient neurological conditions are symptomatically treatable with routinely available medications.
Siddiqi
Omar K
OK
Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA. osiddiqi@bidmc.harvard.edu
Atadzhanov
Masharip
M
Birbeck
Gretchen L
GL
Koralnik
Igor J
IJ
D015526:AIDS Dementia Complex / Q000453:epidemiology; D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D002648:Child; D003141:Communicable Diseases / Q000453:epidemiology*; D015897:Comorbidity; D003906:Developing Countries / Q000706:statistics & numerical data*; D004827:Epilepsy / Q000453:epidemiology; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology*; D019636:Neurodegenerative Diseases / Q000453:epidemiology; D010045:Outpatients / Q000706:statistics & numerical data; D010523:Peripheral Nervous System Diseases / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D013118:Spinal Cord Diseases / Q000453:epidemiology; D055815:Young Adult; D015024:Zambia / Q000453:epidemiology