The prevalence of neurological disorders in older people in Tanzania Dewhurst F, Dewhurst MJ, Gray WK, Aris E, Orega G, Howlett W, Warren N, Walker RW. The prevalence of neurological disorders in older people in Tanzania. Acta Neurol Scand: DOI: 10.1111/j.1600-0404.2012.01709.x. © 2012 John Wiley & Sons A/S Objectives – There are few data on neurological disorders prevalence from low- and middle-income countries, particularly sub-Saharan Africa (SSA) and none specific to the African elderly. We aimed to determined the prevalence of neurological disorders in those aged 70 years and over in a rural African community. Materials and methods – This study was a cross-sectional two-phased community epidemiological survey set in the rural Hai district of Tanzania. Screening was performed with a validated screening questionnaire with high sensitivity and specificity. Positive responders to screening underwent full neurological history and examination to confirm or refute the presence of neurological disorders and to classify the disorder using the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10). Results – Of 2232 participants, there were 384 neurological diagnoses amongst 349 people. The age-adjusted prevalence of people with neurological diagnoses was 154.1 per 1000 (95% CI 139.2–169.1). The age-adjusted prevalence per 1000 of the most common neurological disorders were tremor (48.2), headache (41.8), stroke (23.0), peripheral polyneuropathy (18.6), upper limb mononeuropathy (6.5) and parkinsonism (5.9). Conclusions – This is the first published community-based neurological disorders prevalence study specifically in the elderly in SSA. It reveals a high prevalence of neurological morbidity and demonstrates the contribution neurological disorders make to the non-communicable disease epidemic. This is likely to increase as the population of low-income countries ages constituting a public health dilemma. F. Dewhurst 1,2 , M. J. Dewhurst 1,2 , W. K. Gray 1 , E. Aris 3 , G. Orega 4 , W. Howlett 4 , N. Warren 5 , R. W. Walker 1,2 1 Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK; 2 Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK; 3 Department of Medicine, Muhimbili University College Hospital, Dar-es-Salaam, Tanzania; 4 Kilimanjaro Christian Medical Centre, Moshi, Tanzania; 5 Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle- upon-Tyne, UK Key words: neurological disorders; elderly; prevalence; Tanzania; Africa F. Dewhurst, Department of Medicine, North Tyneside General Hospital, Rake Lane, North Shields, Tyne and Wear NE29 8NH, UK Telefax: +0191 293 2709 e-mail: drfelicitywerrett@doctors.org.uk Accepted for publication June 29, 2012 Introduction Neurological disorders are known to cause significant morbidity and mortality in high-income countries, particularly in the elderly (1). However, little is known about the prevalence of these conditions in sub-Saharan Africa (SSA), a region with a rapidly increasing elderly population (2). There are no up-to-date community-based studies of all cause neurological disorders prevalence in this area with the only published studies preceding the HIV epidemic (3, 4). Anecdotal and projected prevalence figures indicate that neurological disorders also have significant public health consequences in SSA but are contradictory regarding the level of burden. The Global Burden of Disease Study estimated that neurological disorders account for <5% of morbidity in low-income countries (5). Although estimates vary, hospital-based studies from SSA have reported admissions for neurological disorders to account for around 8% of all admissions (6, 7). However, hospital-based studies are rarely representative, especially in low- and mid- dle-income countries, where many people do not attend hospital because of financial constraints or limited coverage of healthcare services. There is an urgent need to document the prevalence of neurological disorders in SSA. Accurate data on level of burden are paramount for evidence-based healthcare planning in resource-poor settings. The primary aim of this 1 Acta Neurol Scand DOI: 10.1111/j.1600-0404.2012.01709.x Ó 2012 John Wiley & Sons A/S ACTA NEUROLOGICA SCANDINAVICA