Prevalence of migraine headache in a rural area of northern Tanzania: a community-based door-to-door survey.

Our aim was to assess the 1-year prevalence of migraine headache in a rural population within the catchment area of the Haydom Lutheran Hospital in northern Tanzania. From December 2003 until June 2004 a community-based door-to-door survey was carried out, using a questionnaire based on the criteria of the International Headache Society, including 1192 households with 7412 individuals selected by multistage cluster-random sampling. The overall 1-year prevalence of migraine headache was found to be 4.3% [316/7412, 95% confidence interval (CI) 3.8, 4.7] with an age-adjusted rate of 6.0% and a male : female ratio of 1:2.94 (P < 0.001). Of these individuals, 132 did not fulfil all criteria for migraine headache, hence, these patients had to be classified as migrainous disorders with a crude prevalence rate of 1.8% (132/7412. 95% CI 1.5, 2.1). The remaining 184 patients met all criteria for migraine resulting in a 1-year prevalence of 2.5% (184/7412, 95% CI 2.1, 2.9) and a male : female ratio of 1:2.51 (P < 0.001). The present survey shows that migraine headache is not uncommon in northern Tanzania. The recorded prevalence of migraine headache is located within the median of previous African prevalence surveys, which confirms the trend of lower migraine frequencies in rural Africa compared with western countries.

Motor and non-motor features of Parkinson's disease.

BACKGROUND: Parkinson's disease (PD) is a common neurodegenerative brain disease in developed countries where population of the elderly is high. PD is increasingly being documented in developing countries where there are rapid demographic changes. Motor features of PD have been documented in Africans in previous studies. However non-motor features such as depression and sleep disturbance have not been well documented. OBJECTIVE: To study the motor and non-motor features of idiopathic Parkinson's disease in Tanzania. DESIGN: A descriptive consecutive referral of patients to the national tertiary care hospital. SETTING: Neurology clinic at Muhimbili National Hospital a major teaching and national referral hospital. RESULTS: Forty two of 1,908 (2.2%) new referralpatients over four years of study satisfied the criteria for idiopathic PD. Of these 25 (59.5%) were males and 17 females. There was no significant difference between sex, in demographic and clinical features. Nevertheless females tended to be older; and the majority of whom were housewives. Three male patients were in advanced stage five and six or UPDRS above 61/108. Thirty nine (92.8%) patients completed BDI and none of these had a BDI score of more than ten. Insomnia was reported in 14(33%) of patients. There was no significant difference between age, sex, clinical stage or UPDRS score. However 12 (28.6%) of 42 patients had been noted to have at least one sleep behaviour disorder and all had mild to moderate disease at stages one to three or UPDRS score of 60/108 or less. CONCLUSION: Idiopathic Parkinson's disease is increasingly being seen in Tanzania due to the ageing population. Majority of patients in this series were in early stage of disease. Depression was conspicuously absent. However sleep behaviour disorder, which is potentially harmful to the patient, bed partners and requires different management, was a common feature that was elicited by direct enquiry in patients with Parkinson's disease.