Prevalence of Parkinson's disease: a door-to-door survey in rural Bolivia.

A door-to-door survey was carried out in rural areas of the Cordillera Province, Bolivia, to determine the prevalence of Parkinson's diseases (PD) in a sample of 9955 subjects. We found five cases of PD on prevalence day, November 1, 1994. The crude prevalence was 50.2/100,000 (95% CI 18.5-124.5) and 286/100,000 (95% CI 28-543) in subjects aged 40 years or more. Our prevalence is close to rates found in other in developing countries.

Epilepsy, cysticercosis, and toxocariasis: a population-based case-control study in rural Bolivia.

OBJECTIVE: To assess the relationship between epilepsy and infection with Taenia solium and Toxocara canis with a case-control study, in the rural area of the Cordillera Province, Bolivia. METHODS: A preliminary two-phase door-to-door prevalence survey determined the prevalence of epilepsy and identified cases and control subjects. At least two control subjects per case were selected, matching on sex, age, and community of residence. Cases and control subjects were assessed serologically for antibodies against T. canis by ELISA and against T. solium by enzyme-linked immunoelectrotransfer blot (EITB). RESULTS: The prevalence survey found 130 confirmed cases of epilepsy, of which 113 were eligible for the case-control study (59 partial seizures and 54 generalized seizures). Two hundred thirty-three control subjects were selected. Multivariable analysis for a matched case-control study was carried out. There was an association between EITB positivity for T. solium and epilepsy with an OR of 1.85 (95% CI 0.99 to 3.4) for all cases. A stronger association was found in those with partial epilepsy with a late onset of disease (15 years and older), where the OR was 3.66 (95% CI 1.10 to 12.10). A positive association was also found with T. canis for all cases with an OR of 2.70 (95% CI 1.41 to 5.19). This increased for those with late-onset partial epilepsy to an OR of 18.22 (95% CI 2.10 to 158.10). CONCLUSION: This finding suggests that both neurocysticercosis and toxocariasis may in part explain the higher prevalence of epilepsy, particularly partial epilepsy, in developing countries.

Lifetime prevalence of Bell's palsy in rural Bolivia: a door-to-door survey.

We carried out a door-to-door survey in rural areas of the Cordillera Province, Bolivia, to determine the prevalence of the most common neurological diseases in a sample of about 10,000 inhabitants. A team of non-doctor health workers administered a standard screening instrument for neurological diseases, a slightly modified version of the World Health Organization protocol. All subjects found positive at the screening phase underwent a complete neurological examination. On screening, we found 1,130 positive subjects, of whom 909 were aged 15 years and above. After the neurological examination, we found 52 cases who had experienced Bell's palsy during their life in the population aged 15 years and above. The lifetime prevalence on November 1, 1994 was 11.1/1,000 (95% confidence interval 7.8-14.5) for the population aged 15 years and above. The prevalence was higher in women than in men (13.7 and 8.7/1,000, respectively) and increased with age, reaching a peak in the group aged 65 years or more (31.7/1,000). Only 3 cases (5.8%) had received medical therapy.

Prevalence of stroke : a door-to-door survey in rural Bolivia.

BACKGROUND AND PURPOSE: We carried out a door-to-door survey in rural areas of the Cordillera Province, Santa Cruz Department, Bolivia. A cluster sample of 10 124 inhabitants was selected, and 9955 subjects were screened. The aim was to determine the prevalence of the most common neurological diseases (epilepsy, stroke, parkinsonism, and peripheral neuropathy) in this population. METHODS: We used a modified version of the World Health Organization screening instrument. On screening we found that 1130 subjects tested positive, and 1027 underwent a complete neurological examination. According to the World Health Organization guidelines, we defined stroke as "rapidly developing clinical signs of focal (or global) disturbance of cerebral functions, lasting more than 24 hours or leading to death, with no apparent cause other than that of vascular origin." We considered only first stroke and excluded a possible stroke. RESULTS: We found 16 subjects (cases) who had experienced 1 complete stroke on prevalent day (November 1, 1994). The crude prevalence of stroke was 174/100 000 (322/100 000 age-adjusted to the world standard population) and 663/100 000 in subjects aged >/=35 years. Prevalence was >2-fold higher in men than in women (247/100 000 and 99/100 000, respectively) and increased rapidly with age. Seven cases were hospitalized and received specific treatment. CONCLUSIONS: Our crude prevalence is lower compared with rates from developed countries, probably because of a high case fatality rate. Our findings are comparable with those reported from other surveys carried out in rural developing countries.

Prevalence of epilepsy in rural Bolivia: a door-to-door survey.

OBJECTIVE: To carry out a door-to-door survey in rural areas of the Cordillera Province, Santa Cruz Department, Bolivia, to determine the prevalence of neurologic diseases (epilepsy, stroke, parkinsonism, and peripheral neuropathy) in a sample of approximately 10,000 inhabitants. METHODS: A team of nondoctor health workers administered a standard screening instrument for neurologic diseases-a slightly modified version of the World Health Organization protocol. All subjects found positive during the screening underwent a neurologic examination. RESULTS: On screening, the authors found 1,130 positive subjects, of whom 1,027 were then investigated by neurologists. On the basis of the definition proposed by the International League Against Epilepsy, we detected 124 epileptic patients (prevalence, 12.3/1,000), 112 of whom had active epilepsy (prevalence, 11.1/1,000) on the prevalence day (November 1, 1994). Peak age-specific prevalence occurred in the 15 to 24-year age group (20.4/1,000). Sex-specific prevalence was higher in women (13.1/1,000) than men (11.4/1,000). Eighty-nine patients (71.8%) underwent a standard EEG recording. Considering both EEG and clinical data, partial seizures were the most common type (53.2%) based on the classification of the International League Against Epilepsy. The mean age at onset was 20.7 years for partial seizures and 13.6 years for generalized seizures. Only 10.5% of patients had received specific treatment for more than 2 months of their life. CONCLUSION: This report on epilepsy prevalence in Bolivia confirms that epilepsy is a major health problem in rural areas of developing countries.

A neuroepidemiological survey in rural Bolivia: background and methods.

A door-to-door survey was carried out in rural areas of the Cordillera province, Santa Cruz Department, Bolivia. A cluster sample of 10,124 inhabitants was selected. The aim was to determine the prevalence of the most common neurological diseases (epilepsy, stroke, parkinsonism and peripheral neuropathy) in this population using a modification of the World Health Organization screening instrument. 1,130 subjects screened positive and were then investigated by neurologists. In this paper we describe the background and methods of the survey and the characteristics of the population.