Neurological Disorder Burden in Faisalabad, Punjab-Pakistan:Data
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View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by eCommons@AKU Pakistan Journal of Neurological Sciences (PJNS) Volume 12 | Issue 3 Article 2 9-2017 Neurological disorder burden in Faisalabad, Punjab-Pakistan:data from the major tertiary carecenters of the city Ghulam Hussain Government College University, Faisalabad, Pakistan, [email protected] Asif Shahzad Government College University, Faisalabad, Pakistan Haseeb Anwar Government College University, Faisalabad, Pakistan Shahid Mahmood Baig PIEAS, Faisalabad, Pakistan Asghar Shabbir COMSATS Institute of Information Technology, Islamabad, Pakistan. See next page for additional authors Follow this and additional works at: https://ecommons.aku.edu/pjns Part of the Neurology Commons Recommended Citation Hussain, Ghulam; Shahzad, Asif; Anwar, Haseeb; Mahmood Baig, Shahid; Shabbir, Asghar; and De Aaguilar, Jose-luis Gonzalez (2017) "Neurological disorder burden in Faisalabad, Punjab-Pakistan:data from the major tertiary carecenters of the city," Pakistan Journal of Neurological Sciences (PJNS): Vol. 12 : Iss. 3 , Article 2. Available at: https://ecommons.aku.edu/pjns/vol12/iss3/2 Neurological disorder burden in Faisalabad, Punjab-Pakistan:data from the major tertiary carecenters of the city Authors Ghulam Hussain, Asif Shahzad, Haseeb Anwar, Shahid Mahmood Baig, Asghar Shabbir, and Jose-luis Gonzalez De Aaguilar This original article is available in Pakistan Journal of Neurological Sciences (PJNS): https://ecommons.aku.edu/pjns/vol12/iss3/2 Corresponding to: Ghulam Hussain, Department of Physiology, Liaquat Block, 1st Floor. New campus, Government College University, Jhang Road, 3800 Faisalabad. Contact: +923006654101 Email: [email protected] The mortality rate and burden of disability caused by NDs is higher than any other major disease worldwide–25. The overall prevalence of NDs is 6.5% and incidence trends have shown an alarming rate of increase over time3. Demographic, geographic, and socioeconomic conditions are major factors that affect the epidemiology oNDs. Previous us research has shown that prevalence and incidence of NDs is positively correlated with the economic condition of a given country. The burden of NDs increases as a country expands economically3,6. In lower-income countries,the reported prevalence of NDs ranges from 4% to 5%,whileprevalence in countrieswith higher GDP is 10-11%2,3,7. The higher rate of NDs in developed countries may be due to their more robust system of public health services and health- MATERIALS AND METHODS related facilities that screen and provide health services for the average patient. It has been In the present study, study subjects were recruited documented that 6.75% of the American population from the patient population at the outpatient neurology and6% of the Population have been diagnosed with and psychiatry departments of Allied Hospital, DHQ NDs. Hospital, Aziz Fatima Trust Hospital, Faisal Hospital, In recent years, the burden of Nds in developing and Al-Noor Hospital in Faisalabad, Punjab-Pakistan. countries has continued to increase; this grow this The inclusion criteria for selecting the hospitals were correlated with increasing epidemiological data, that the facility was well-equipped, possessed prolonged life expectancy, improved health facilities, functional basic and advanced facilities for diagnosis facilitated access to healthcare centers, provision of of complicated NDs, and had a sufficient patient advanced diagnostic technology, and a trend in population for recruitment at the outpatient facility. The urbanization among the population. Although there are selected tertiary care centers are the highest-volume data regarding the incidence and prevalence of ND sin centers in Faisalabad district. The health care centers developing countries of Asia, such as China, India, and were selected from4 different corners of the city in Sri Lanka, these data may not be generalizable to order to acquire representative data from each region Pakistan, due to differing social, geographical, of the district. Furthermore, a mix of government and religious, cultural, and ethnic aspects unique to those private-sector hospitals were selected to ensure the in countries. Therefore, it is necessary to conduct clusion of an economically divers ecohort that would epidemiological studies in Pakistan to collect and be more representative of the population in general. A analyze reliable data for this region of the world . structured questionnaire was used to gather basic data The prevalence of Nds in India ranges from about the patients receiving care in the selected 967–4,070/100,000 with a mean of 2,394/100,000 hospital departments. population. Such prevalence indicates that over 30 The data were collected from March 2015 to May 2015. million people are living with NDs in this country with Prior authorization was sought from the hospital the second largest population in the world. The administration for collection of data. The physicians prevalence of common disorders, such as stroke, and psychiatrists of participating patients were epilepsy, tremors, Parkinson's disease (PD), and requested to make a detailed diagnosis based on the mental retardation, is not uniform across the different available medical tests for the possible ND. Patients regions of the country . were interviewed and data were recorded on The overall crude prevalence of NDs in Saudi Arabia questionnaires. Patients undergoing their first clinical was reported to be 131/1,000population .Recent visit were excluded, as their clinical diagnosis may not reports indicate about68.5/10,000 prevalence of NDs have been fully determined. Patients with confirmed in the pediatric population of Saudi Arabia . diagnoses were included in the study, and data were Published data regarding the epidemiology of major collected from the subjects after obtaining consent of NDs in Pakistan is limited, and most available either the patient or his/her care giver. The available information are hospital-based estimations or record of medications and treatment was also physician-collected data, limited to a few cities. These collected for further verification as needed. data are likely not nationally representative . In Information about gender, age, marital status, type of comparison to neighboring countries, it maybe disorder, familial history for the disorders of interest, possible to determine aggregation of the existing, and consanguineous marriage were collected for disparate data sources. The existing information the further analysis of related risk factors. prevalence of NDs in Pakistan based concerning the prevalence of NDs in selected cities of Pakistan INSTITUTIONAL REVIEW BOARD APPROVAL indicate that the burden of NDs is a serious concern. Epidemiological data concerning selected Nds are The Institutional Review Board (IRB) of Government available, but this information is limited to particular College University, Faisalabad-Pakistan carefully locations and, therefore, cannot be generalized to reviewed and granted approval for this study. determine the overall burden of NDs in Pakistan nationally. Most available data are from the city of RESULTS Karachi, while prevalence and incidence in the other mega-cities of Pakistan have yet to be investigated. In The overall burden of NDs in Faisalabad District was the present study, we focused our evaluation of NDs in assessed in the 3,068 study participants. The rate of Faisalabad, the third largest city of Pakistan. To our each ND reported in this population was as follows: . knowledge, this is the first study concerning the depression 19.6% (n = 602), epilepsy 16.6% (n = 508), prevalence and burden of NDs at the leading tertiary migraine 15.2 % (n = 466),disc prolapse 8.8% (n = care centers of this mega-city. 269), paralysis 8.5% (n = 262), trauma 5.3% (n = 163), P A K I S T A N J O U R N A L O F N E U R O L O G I C A L S C I E N C E S 0 4 V O L . 1 2 ( 3 ) J U L - S E P 2 0 1 7 brain hemorrhage 5% (n = 153), PD3% (n = 92), schizophrenia 2.7% (n = 83), congenital anomaly 2.2% -F.History +F.History (n = 68), tumor 1.6% (n = 50), dementia 1.7% (n = 52), P arkinson‘s D isease 20.0 80.0 mania 0.8% (n = 25), acute psychological disorder S chizophrenia 76.5 23.5 1.4% (n = 43), disruptive behavior disorder 0.6% (n = D isc P rolapse 23.1 76.9 19), bipolar affective disorder 0.7% (n = 22), and D epression miscellaneous 6.2% (n = 191) (Figure 1). 88.5 11.5 E pilepsy 69.2 30.8 25.0 M igraine 67.0 33.0 6 . O verall 9 73.0 27.0 1 20.0 6 . 2 . 6 1 0.0 5 20.0 40.0 60.0 80.0 100.0 s 1 t n 15.0 % of patients e i t 8 a 5 . 10.0 8 8 Figure 3. Percentage of Patients with Positive p 2 f . 3 0 . 6 . o Family History of ND (N = 382) 5 5 0 7 % . 5.0 2 . 6 7 3 2 4 . 8 2 . 6 7 . 1 1 1 0 0 0 0.0 n r o y e e is a e se ia ly o ia ia s er r s i s in s s m g a n a t n es d e u Nds were more prevalent in the female group as ss p ra p ly u a e e m n a n r rd o e ile g ia a a rh s r m u e Ill so o e r p i o r r o i h o T m M l i is n p E M r a T D p n e a D d lla e P P m s zo A D ic ur e D c e n’ i al g o e c compared to the male group in Faisalabad. Among the is a o ch ti lo vi tiv is D H s S n o a c M in in e ch eh fe a rk ng y B af r a o s e r study population, 41.5% (n = 1300) were male gender B P C P iv la te pt o cu ru ip A is B D and 58.5% (n = 1829) were female gender.