eNeurologicalScieNeurologicalSci Vol 3

June 2016 | Pages 1-84

Neurological Disorders in Africa

Edited by Mayowa Owolabi, Ana-Claire Meyer, Fred Sarfo



The establishment of the African Academy of Neurology

Mansour Ndiaye, Augustina Charway-Felli, On behalf of the AFAN Board of Directors

African Neurology has come of age. On the 29–31 August 2015 a landmark meeting was held in Dakar, Senegal. Delegates from 33 African countries representing their national neurologic societies and associations gathered to decide on the future of Neurology in Africa. The meeting was held under the aegis of the World Federation of Neurology (WFN) Africa Initiative Task and Advisory Force for Africa (TAFNA) with the support of the President of the WFN, Professor Raad Shakir. The Representatives of TAFNA were Professors Amadou Gallo Diop and Riadh Gouider of Senegal and Tunisia respectively.



An insight of sleep disorders in Africa

Jorge F. Aragón-Arreola, César A. Moreno-Villegas, David A. Armienta-Rojas, Alberto K. De la Herrán-Arita

Sleep is a recurrent physiologic and fundamental process in every human being, regardless of ethnicity, gender, birthplace, or occupation; however, the features of sleep are swayed by genetic background and environmental influences. All these factors have an intricate relationship, and arise from a complex and assorted genetic repertoire in the alleles that promote a higher genetic variation in human populations. Sleep disorders have become an uprising public health problem in the modern society; in addition, the correlation between sleep disorders and the development of late chronic diseases has been extensively studied, finding an important causality between them.


Original Articles

Building neurosurgical capacity in low and middle income countries

Anthony Fuller, Tu Tran, Michael Muhumuza, Michael M. Haglund

Neurosurgery capacity in low- and middle-income countries is far from adequate; yet burden of neurological diseases, especially neuro-trauma, is projected to increase exponentially. Previous efforts to build neurosurgical capacity have typically been individual projects and short-term missions. Recognizing the dual needs of addressing disease burden and building sustainable, long-term neurosurgical care capacity, we describe in this paper an ongoing collaboration between the Mulago Hospital Department of Neurosurgery (Kampala, Uganda) and Duke University Medical Center (Durham, NC, USA) as a replicable model to meet the dual needs.

Neuroscience research in Africa: Current status

Foad Abd-Allah, Najib Kissani, Anthony William, Mohammed Ibrahim Oraby, Ramez Reda Moustafa, Ehab Shaker, Mohamed Soliman El-Tamawy, Raad Shakir

There are limited data on the contribution of the African continent to neuroscience research and publications. This review aims to provide a clear view on the state of neuroscience research among African countries, and to compare neuroscience research within the 52 African countries. A literature review search was conducted for all published articles by African authors in both local and international journals using Medline and other primary databases. Neuroscience represents 9.1% of the total medical publications.

Disregard of neurological impairments associated with neglected tropical diseases in Africa

Emmanuel Quansah, Esther Sarpong, Thomas K. Karikari

Neglected tropical diseases (NTDs) affect people in the bottom billion poorest in the world. These diseases are concentrated in rural areas, conflict zones and urban slums in Africa and other tropical areas. While the World Health Organization recognizes seventeen priority NTDs, the list of conditions present in Africa and elsewhere that are eligible to be classified as NTDs is much longer. Although NTDs are generally marginalized, their associated neurological burden has been almost completely disregarded.

Does the survival motor neuron copy number variation play a role in the onset and severity of sporadic amyotrophic lateral sclerosis in Malians?

Modibo Sangare, Ilo Dicko, Cheick Oumar Guinto, Adama Sissoko, Kekouta Dembele, Youlouza Coulibaly, Siaka Y. Coulibaly, Guida Landoure, Abdallah Diallo, Mamadou Dolo, Housseini Dolo, Boubacar Maiga, Moussa Traore, Mamadou Karembe, Kadiatou Traore, Amadou Toure, Mariam Sylla, Arouna Togora, Souleymane Coulibaly, Sékou Fantamady Traore, Brant Hendrickson, Katherine Bricceno, Alice B. Schindler, Angela Kokkinis, Katherine G. Meilleur, Hammadoun Ali Sangho, Brehima Diakite, Yaya Kassogue, Yaya Ibrahim Coulibaly, Barrington Burnett, Youssoufa Maiga, Seydou Doumbia, Kenneth H. Fischbeck

Spinal muscular atrophy (SMA) and sporadic amyotrophic lateral sclerosis (SALS) are both motor neuron disorders. SMA results from the deletion of the survival motor neuron (SMN) 1 gene. High or low SMN1 copy number and the absence of SMN2 have been reported as risk factors for the development or severity of SALS.

Incidence and risk factors for neuropsychiatric events among Ghanaian HIV patients on long-term non-nucleoside reverse transcriptase inhibitor-based therapy

Fred S. Sarfo, Maame A. Sarfo, David Chadwick

Non-nucleoside reverse transcriptase inhibitor (NNRTI)-based antiretroviral therapy (ART) is associated with neuropsychiatric toxicity. Little is known about the risk of short- and long-term neuropsychiatric toxicity in sub-Saharan Africa, where NNRTIs are widely used in first-line combination ART. This observational study assessed the risk of neuropsychiatric toxicity in Ghanaian patients starting first-line ART between 2004 and 2010 at a single centre.

Economic burden of stroke in a rural South African setting

Mandy Maredza, Lumbwe Chola

Stroke is the second leading cause of mortality and leading cause of disability in South Africa yet published data on the economic costs of stroke is lacking particularly in rural settings.

Non-motor signs in patients with Parkinson's disease at the University Hospital of Point "G", Mali

Boubacar Maïga, Aïssata Koné, Guida Landouré, Toumany Coulibaly, Modibo Sangaré, Kekouta Dembélé, Marième Soda Diop, Lassana Cissé, Sami Mohamed Lemine Dadah, Mamadou Konaté, Catherine Coulibaly, Adama Seydou Sissoko, Thomas Coulibaly, Mamadou Karambé, Cheick Oumar Guinto, M. Moustapha Ndiaye, Mouhamadou Mansour Ndiaye, Moussa Traoré

Despite significant progress in the field of scientific research on Parkinson's disease (PD), the prevalence and pathophysiology of its non-motor signs remains less understood than the classic motor signs of bradykinesia, rigidity, tremor and postural instability. Data covering this topic are rare in Africa, and almost non-existent in sub-Saharan Africa. Thus, this study aims to highlight the frequency of certain non-motor signs in PD patients followed in the Department of Neurology of the University Hospital Point "G", Bamako, Mali.

Types, risk profiles, and outcomes of stroke patients in a tertiary teaching hospital in northern Ethiopia

Sennay A. Gebremariam, Hannah S. Yang

Stroke is becoming an increasingly serious public health issue in Ethiopia and the paucity of data specific to the Ethiopian setting is limiting the formulation of an appropriate response.

Knowledge and practice concerning swallowing disorders in hemiplegic patients among nurses of Bobo–Dioulasso urban primary health care centers in Burkina Faso

Jeoffray Diendéré, Appolinaire Sawadogo, Athanase Millogo, Alassane Ilboudo, Christian Napon, Nicolas Méda, Jean Kaboré, Ziemlé-Clément Méda, Jean Testa, Pierre-Marie Preux, Jean-Yves Salle, Jean-Claude Desport

The quality of management of swallowing disorders (SD) from admission onwards influences the patients' nutritional status and their prognosis. Neurological diseases are the main causes of SD, affecting one in three patients with hemiplegia (Hp). In Burkina Faso (BF), primary health care center (PHCC) nurses are the first to manage these patients, but there are no data related to their management of SD. The study aimed to assess knowledge and practices regarding SD in Hp among PHCC nurses in Bobo–Dioulasso, a main center for care of Hp in BF.

Cognitive function in patients with newly diagnosed HIV infection in a tertiary health facility in south – west Nigeria: Assessment using computer-assisted neuropsychological test battery

Taofiki A. Sunmonu, Olubunmi A.Ogunrin, Frank A. Imarhiagbe, Lukman F. Owolabi, Morenikeji A. Komolafe, Olayinka S. llesanmi

Cognitive dysfunction is common among patients with human immunodeficiency virus (HIV) infection however there are few reports from sub-Saharan Africa.

Socio-cultural adaptation and standardization of Dubois' five words testing in a population of normal subject in Mali, West Africa

Cheick O. Guinto, Toumany Coulibaly, Zeinab Koné, Souleymane Coulibaly, Boubacar Maiga, Kekouta Dembélé, Lassana Cissé, Mamadou Konaté, Thomas Coulibaly, Adama S. Sissoko, Mamadou Karambé, Barrington Burnett, Guida Landouré, Moussa Traoré

Dubois' five words testing (5WT) is a verbal memory test that depends on many parameters. The aim of this study is to adapt Dubois' 5WT to the Malian socio-cultural conditions to (i) determine performances of normal subjects to the 5WT and (ii) provide reference scores of the 5WT.

Short term stroke outcome is worse among individuals with sickle cell trait

P. Olowoyo, M.O. Owolabi, B. Fawale, A. Ogunniyi

Most (86%) of the global stroke mortality are from low- and middle-income countries (LMIC) including African countries which have the highest prevalence of the sickle cell trait (Hb AS). The effects of this trait on stroke occurrence and outcome are poorly understood. We aimed to investigate the effects of the sickle cell trait on the 30-day stroke mortality in Nigerian-Africans.

Profile of neurological disorders in an adult neurology clinic in Kumasi, Ghana

Fred Stephen Sarfo, John Akassi, Elizabeth Badu, Aham Okorozo, Bruce Ovbiagele, Albert Akpalu

Although the burden of neurological disorders is highest among populations in developing countries there is a dearth of data on the clinical spectrum of these disorders.

Validation of the 8-item questionnaire for verifying stroke free status with and without pictograms in three West African languages

Fred S. Sarfo, Mulugeta Gebregziabher, Bruce Ovbiagele, Rufus Akinyemi, Lukman Owolabi, Reginald Obiako, Kevin Armstrong, Oyedunni Arulogun, Albert Akpalu, Sylvia Melikam, Raelle Saulson, Carolyn Jenkins, Mayowa Owolabi, on behalf of SIREN

The Questionnaire for Verifying Stroke-free Status (QVSFS) has been validated in Western populations as a method for verifying stroke-free status in participants of clinical, epidemiological and genetic studies. This instrument has not been validated in low-income settings where populations have limited knowledge of stroke symptoms and literacy levels are low.

Nodding syndrome: 2015 International Conference Report and Gulu Accord

P.S. Spencer, D.L. Kitara, S.K. Gazda, A.S. Winkler

Nodding syndrome is a pediatric epileptic encephalopathy of apparent environmental origin that was first described in Tanzania, with recent epidemics in South Sudan and Uganda. Following a brief description of the medical geography, setting and case definition of this progressive brain disorder, we report recent advances relating to etiology, diagnosis and treatment described in papers given at the 2nd International Conference on Nodding Syndrome held in July 2015 in Gulu, Uganda. The target audience for this report includes: anthropologists, entomologists, epileptologists, health care workers, helminthologists, medical researchers, neuroepidemiologists, neurologists, neuroscientists, neuropathologists, nurses, nutritional scientists, primary health care physicians, psychiatrists, public health practitioners, toxicologists, and virologists.


Letter to the Editor

Consanguinity and rare neurological disease. A five year experience from the Korle Bu Teaching Hospital, Accra, Ghana

E.V. Badoe

Marriage between close biological kin is not regarded as advantageous in the western world but in other parts of the world, consanguineous unions persist. Consanguineous marriage increases the birth prevalence of individuals with recessive disorders. In Accra, Ghana, consanguinity is beginning to emerge as a significant cause of rare neurological disease at the central referral hospital at Korle Bu in Ghana.