Zusammenfassung
Der Prävalenz neurologischer Erkrankungen und kranieller Pathologien in Afrika wurde bisher wenig Aufmerksamkeit geschenkt. Ziel dieser Untersuchung war es, einen Überblick über kranielle Pathologien in einem ländlichen und einem städtischen ostafrikanischen Krankenhaus zu bekommen, um mögliche Unterschiede im Krankheitsspektrum sichtbar zu machen. Im ländlichen Haydom Lutheran Hospital konnten die Daten von 726 Patienten, welche eine kranielle Computertomographie (CT) erhalten hatten, ausgewertet werden. Im städtischen Aga Khan Krankenhaus war es möglich, die Akten von 1975 CT- und von 537 MRI-Patienten (Magnetresonanztomographie) zu verwenden. Die Mehrzahl der Patienten war in allen drei Populationen männlich. Das mediane Alter im städtischen Einzugsgebiet war mit 48 (CT; min–max 0–95 Jahre) und 39 (MRI; 1–89) Jahren deutlich höher als im ländlichen (CT; 32 Jahre; 0–102). Die dominierenden Krankheitsgruppen in den städtischen Untersuchungsreihen waren Schlaganfall, extrakranielle Infektion, zerebrale Atrophie und Tumor. In der ländlichen Untersuchungsreihe stachen eine große Anzahl von traumatisch bedingten Pathologien, gefolgt von Schlaganfällen und zerebralen Infektionen und Infestationen besonders hervor. Die größten Unterschiede im Krankheitsspektrum betrafen Fälle mit den folgenden Diagnosen: Zerebrale Infektionen und Infestationen sowie Hydrozephalus wurden in Haydom deutlich häufiger diagnostiziert. Schlaganfälle und zerebrale Atrophien wurden hingegen öfter im städtischen Krankenhaus dokumentiert. 51 Patienten der ländlichen Studienpopulation waren bekannt HIV positiv. Innerhalb dieser Untergruppe wurde eine klare weibliche Mehrheit festgestellt, während sich bei den 57 HIV positiven Fällen in der Stadt eine nahezu ausgeglichene Geschlechterverteilung zeigte. In beiden Gruppen waren zerebrale Infektionen und Infestationen häufiger als in der jeweiligen Gesamtpopulation.
Summary
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.
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Maier, D., Doppler, M., Gasser, A. et al. Imaging-based disease pattern in a consecutive series of cranial CTs and MRIs in a rural and an urban Tanzanian hospital: a comparative, retrospective, neuroradiological analysis. Wien Klin Wochenschr 122 (Suppl 3), 40–46 (2010). https://doi.org/10.1007/s00508-010-1436-8
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DOI: https://doi.org/10.1007/s00508-010-1436-8