title: Yield of training exchanges between Europe and Sub-Saharan Africa.
abstract: Opportunities that allow neurologists-in-training from Western Europe and Sub-Saharan Africa to benefit from exchanges between their respective neurological departments are rare. In a pilot exchange program, we compare the patterns of neurological diseases encountered in neurological wards of public hospitals in Brussels and Yaoundé to underline educational benefits. For 5 months the age, sex, mortality, HIV cases and clinical characteristics of admitted patients were prospectively analyzed. Eighty Cameroonian and 105 Belgian patients were classified into the following neurological entities: infectious, vascular, immune-related, epileptic, degenerative, neoplastic, psychogenic and movement disorders. Means and proportions were compared using Student's test and Fisher's exact test, respectively. Patients were younger in Yaoundé (mean age 45.3 vs. 54.0 years, p = 0.002), but died four times more (23.75 vs. 4.75 % of admissions, p < 0.001). HIV proportion was 43.75 % in Yaoundé and nil in Brussels. Infectious complications were responsible for 100 % of deaths in HIV-positive patients against 44 % in HIV-negative patients (p = 0.0108). The proportions of vascular, neoplastic and movement disorders were comparable. Neurological complications of infections occurred ten times more in Yaoundé (69 vs. 6.7 %, p < 0.0001). Multiple sclerosis accounted for 11.4 % of admissions in Brussels but other immune-related diseases were more frequent in Yaoundé (8.75 vs. 2 %, p = 0.04). Epileptic, degenerative and psychogenic diseases were more frequent in Brussels: 38.1 versus 12.5 % (p < 0.001), 16.2 versus 5 % (p < 0.0194) and 3.75 versus 14.3 % (p < 0.0224), respectively. Exchanges between Western Europe and Sub-Saharan neurological wards could offer neurologists-in-training firsthand experience with diseases seldom met; otherwise, an understanding of different healthcare systems and a better understanding of the concept of neurology as a public health challenge.
authors: Department of Neurology, CHU-Brugmann, Hôpital Erasme, 808, route de Lennik, 1070, Brussels, Belgium. gillesnaeije@yahoo.com
authors: G
authors: G
authors: Naeije
authors: F N
authors: FN
authors: Yepnjio
authors: A-C
authors: AC
authors: Bissek
authors: E N
authors: EN
authors: Tabah
authors: G
authors: G
authors: Tatah
authors: J Y
authors: JY
authors: Fonsah
authors: Y
authors: Y
authors: Fogang
authors: C
authors: C
authors: Kuate
authors: B
authors: B
authors: Dachy
authors: A K
authors: AK
authors: Njamnshi
mesh_terms: D000328:Adult; D000368:Aged; D001530:Belgium; D002163:Cameroon; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000401:mortality*; D009462:Neurology / Q000193:education*; D010865:Pilot Projects; D011446:Prospective Studies; D012307:Risk Factors