Department of Neurology, Medical University Innsbruck, Innsbruck, Austria.
Wien Klin Wochenschr. 2010 Oct;122 Suppl 3:40-6. doi: 10.1007/s00508-010-1436-8.
The prevalence of neurological diseases and cranial pathologies in sub-Saharan Africa remains a very little investigated field. This study aims at providing an imaging-based overview of cranial pathologies in two Tanzanian hospitals and at identifying possible differences in the spectrum of diseases between rural and urban African populations. At rural Haydom Lutheran Hospital (Manyara region) the data of 726 patients were included in a retrospective survey. At urban Aga Khan Hospital (Dar es Salaam) the data of 1975 patients who had undergone Computed Tomography (CT) and of 537 Magnetic Resonance Imaging (MRI) patients were obtained. All three surveys showed a clear male preponderance within the populations. The median age of the patients was higher in the city (urban CT 48 years; range 0-95/MRI 39 years; 0.1-89; rural CT 32 years; 0-102). In the urban series stroke, extracranial infections, cerebral atrophy and tumours formed the main groups of diagnoses. Amongst rural patients traumatic pathologies, followed by stroke and cerebral infections/infestations were the most common diagnoses. The most striking differences were noticed with cases compatible with cerebral infections/infestations and hydrocephalus being reported more frequently in the rural population. On the other hand stroke and cerebral atrophy were more frequent amongst urban patients. In the rural catchment area the data of 51 HIV-positive CT patients could be obtained, showing a clear female preponderance. Within the urban HIV-positive subgroup of CT patients (n = 57), the gender distribution was almost equal. Furthermore, in both HIV-positive populations the proportion "compatible with cerebral infections/infestations" was higher than amongst the overall study populations. In conclusion, cranial pathologies seem to differ widely in rural and urban areas of Tanzania in particular with respect to cerebral infections and vascular disease.
撒哈拉以南非洲的神经疾病和颅部病变的流行仍然是一个研究甚少的领域。本研究旨在提供基于影像学的坦桑尼亚两家医院颅部病变概述，并确定农村和城市非洲人群疾病谱的可能差异。在农村的 Haydom Lutheran 医院（马拉维地区），对 726 名患者的数据进行了回顾性调查。在城市的 Aga Khan 医院（达累斯萨拉姆），获得了 1975 名接受计算机断层扫描（CT）和 537 名磁共振成像（MRI）的患者的数据。这三个调查都显示出人群中明显的男性优势。城市患者的中位数年龄更高（城市 CT 为 48 岁；范围为 0-95/MRI 为 39 岁；范围为 0.1-89；农村 CT 为 32 岁；范围为 0-102）。在城市系列中，中风、颅外感染、脑萎缩和肿瘤构成了主要的诊断组。在农村患者中，创伤性病变、中风和脑感染/寄生虫感染是最常见的诊断。在农村地区，与脑感染/寄生虫感染和脑积水相符的病例更为常见，这一点尤为明显。另一方面，中风和脑萎缩在城市患者中更为常见。在农村地区，可以获得 51 名 HIV 阳性 CT 患者的数据，这些患者中明显女性居多。在城市 HIV 阳性 CT 患者亚组（n = 57）中，性别分布几乎相等。此外，在两个 HIV 阳性人群中，“与脑感染/寄生虫感染相符”的比例均高于总体研究人群。总之，颅部病变在坦桑尼亚的农村和城市地区差异很大，特别是在脑感染和血管疾病方面。
