Addressing the Burden, High Treatment Gap and Societal Impact of Neurological Disorders in Nigeria: The Results of a Neuro-Epidemiological Survey in a Rural Riverine Community of Southwest Nigeria

Abstract

Background: Over the last few years, there has been a steady increase in the incidence of neurological diseases in Nigeria particularly stroke, epilepsy and dementia. Therefore, it was needful to determine the current burden imposed by such disorders in Nigeria especially in the rural communities. This survey was carried out in Ilie community, Southwest Nigeria. The aim of this report is to address   some of the findings of the survey including the high treatment gap, social issues and societal impact of these common neurological disorders on the community. Methods: The study was carried out in a remote community known as Ilie which is located in Osun state, Nigeria. Ilie ward was screened from door to door, to identify people who had suffered from Neurological Disorders (ND) (lifetime prevalence).In determining the prevalence of ND, a two-phase cross-sectional study design was adopted. The first phase involved the demographic data collection from each screened household and the administration of WHO screening questionnaire for ND by the trained field interviewers. The second phase was the clinical examination of the participants who were positivenduring the first phase of screening by the neurologists to confirm the diagnosis of the identified neurological disease. Social issues such as access to education, employment opportunities and marital prospects as well as treatment issues were also assessed. Results: In the first phase, the numbers of individuals screened were 2212, all from 231 households. The female participants accounted for 1111(50.3%) and males were 1101(49.7%), therefore the females were slightly more than the males. Thirty-three (33) cases of ND were detected giving a point prevalence of 1.9% and epilepsy was discovered to be the commonest. Traditional medicine as well as spiritual healing was the mainstay of treatment. Conclusions: The burden of neurological disease was still high in this rural community of Southwest Nigeria and knowledge, social and treatment issues were still present.