Neurological Disease Burden in two Semi-urban Communities in South East Nigeria

BACKGROUND: Neurological disorders are a significant cause of morbidity and mortality worldwide. Urban hospital -based studies give some perspectives on the burden of neurological disease but there are no community- based studies from South East Nigeria.AIM: This study sought to screen for the scope and pattern of neurological dysfunction affecting inhabitants of two semi-urban communities in Enugu, South East Nigeria.METHODS: A descriptive, cross- sectional, questionnaire- based study of inhabitants living in Alfred Camp and Udi Siding communities in Enugu was carried out in March 2008. Using a structured questionnaire, house- to- house interview of the residents was conducted by doctors trained for this purpose. Residents' knowledge and experience of clinical features that suggest neurological dysfunction were ascertained. Informed consent was obtained and ethical approval obtained from the Ethics Committee of the University of Nigeria Teaching Hospital Enugu. Data obtained was analyzed using SPSS version 13.5.RESULTS: Completed questionnaires were 239 in number. There were 138 males and 101 females with age range of 18 -75 years. Most respondents, 127 (53.1%), were aged 21 -30 years. Pain syndromes were most common with headache, low back pain and neuropathic pain accounting for the top 3 neurological disorders.CONCLUSION: This study has suggested that pain syndromes affect large numbers of people ordinarily resident in semi-urban communities in Enugu, South East Nigeria. These syndromes have an effect on quality of life. There is need for further large scale studies as well as increased public health strategies for addressing neurological diseases including pain disorders.KEY WORDS: burden; neurological disease; Nigerian communitie

Worldwide Disparities in Recovery of Cardiac Testing 1 Year Into COVID-19

BACKGROUND The extent to which health care systems have adapted to the COVID-19 pandemic to provide necessary cardiac diagnostic services is unknown.OBJECTIVES The aim of this study was to determine the impact of the pandemic on cardiac testing practices, volumes and types of diagnostic services, and perceived psychological stress to health care providers worldwide.METHODS The International Atomic Energy Agency conducted a worldwide survey assessing alterations from baseline in cardiovascular diagnostic care at the pandemic's onset and 1 year later. Multivariable regression was used to determine factors associated with procedure volume recovery.RESULTS Surveys were submitted from 669 centers in 107 countries. Worldwide reduction in cardiac procedure volumes of 64% from March 2019 to April 2020 recovered by April 2021 in high- and upper middle-income countries (recovery rates of 108% and 99%) but remained depressed in lower middle- and low-income countries (46% and 30% recovery). Although stress testing was used 12% less frequently in 2021 than in 2019, coronary computed tomographic angiography was used 14% more, a trend also seen for other advanced cardiac imaging modalities (positron emission tomography and magnetic resonance; 22%-25% increases). Pandemic-related psychological stress was estimated to have affected nearly 40% of staff, impacting patient care at 78% of sites. In multivariable regression, only lower-income status and physicians' psychological stress were significant in predicting recovery of cardiac testing.CONCLUSIONS Cardiac diagnostic testing has yet to recover to prepandemic levels in lower-income countries. Worldwide, the decrease in standard stress testing is offset by greater use of advanced cardiac imaging modalities. Pandemic-related psychological stress among providers is widespread and associated with poor recovery of cardiac testing. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation