Table 1 – Overview of studies on Parkinsonism and risk factors in sub-Saharan African countries
Author, year of Country
publication
Setting
Bower [101],
2005
Hospital
Ethiopia
Akinyemi [102], Nigeria
2008
Hospital
Design /
Period of
study
Crosssectional
2003-2004
Population characteristics
Diagnosis criteria
720 patients; 109 (15·1%)
Not provided
with movement disorders
including 71 men; age 52 y.
(13-80)
Case-control 51 patients (men 37) with PD UK Parkinson’s
2005-2005 and 50 controls
Disease Society (UKPDS)
Brain Bank criteria
Cosnett [103],
1988
South Africa Hospital-
Crosssectional
1979-1985
2638 patients seen in
neurological consultations
Clinical
Dotchin [104],
2008
Tanzania
Community
Crosssectional
161,071 inhabitants
Screening questionnaire/
confirmed by a specialist
Schoenberg [78], Nigeria
1988
USA
Community
Crosssectional
Crosssectional
Clinical
Winkler [105],
2009
Hospital
Black population aged 40+
3412 participants
Black population aged 40+
3521 black participants and
5404 white participants.
n = 8676 patients admitted
(740 with neurological
diseases)
1569 people, age 50-110
years
Tanzania
Community
Community
Kengne [39],
2006
Cameroon
Hospital
Lombard
Zimbabwe
[106],1978
Osuntokun [10], Nigeria
1979
Hospital
Osuntokun [69], Nigeria
1987
Community
Haylett [107],
2012
Hospital
South Africa Hospital
Crosssectional
2003
Crosssectional
2003-2005
Crosssectional
1993-2001
Clinical
UK Parkinson’s
Disease Society Brain Bank
criteria
UK Parkinson’s
Disease Society Brain Bank
criteria
4041 neurologic consultations Not provided
145 (3.9%) had
neurodegenerative diseases
Crosssectional
Crosssectional
1966-1976
Total patients admitted:
Not provided
83,453 blacks, 34,952 whites
217 patients with
Etiological diagnosis via
parkinsonism
history, lab tests,
neuroimaging and autopsy
Crosssectional
1985
Crosssectional
Total participants surveyed:
18,954
Questionnaire developed by
author
Prevalence
Profile of
Comments
parkinsonism
patients
7.2% of all admissions (PD: N:52; PD:88%
Review of medical files
6.4% )
Age (at onset): 57y
(30-80)
Men: 75%
NA
N:51; PD: 100% 22% patients with PD had
Age (at onset): 70y cognitive ddysfunction, with
(41-80)
age at PD onset as sole
Men:72%
predictor
Blacks: 23.6/1000
N:81; PD: 14%
Retrospective review of
Indians: 45.5/1000
Age: NA
medical files
Whites: 61.6/1000
Men: NA
Overall: 40/100,000
Men: 64/100,000
women: 20/100,000
N: 32; PD:100% Age adjustment to the UK
Age (at onset): 69y population; Age at onset : 29–
(37-90)
90; Mean duration 5.1 y
Men: 72%
Age adjusted:
N: 2; PD:100%
67/100 000
Age/Men: NA
Age adjusted:
N: 12; PD: 100%
Blacks: 341/100,000
Age: NA
Whites: 352/100,000
Men: NA
0.1% (all patients)
N: 8; PD:37%
1.1% (Patients with
Age: >32y
neurological diseases
Men: 100%
235/100,000
N: 18
None of the 18 screenedAge: 50-100y
positive was confirmed as
Men: 50%
havPD
48.8% of all
N: 41; PD 100% 4 selected neurodegenerative
neurodegenerative diseases; Age: 15-84y
brain disorders: dementia, PD,
1.01% of all neurologic
Men: 73.2%
ALS, chorea
consultation
Blacks: 20.6/100,000
N: 50 (17 blacks) Retrospective review of
Whites: 283.2/100,000
Age/men: NA
medical files
NA
N: 217; PD 38% All patients evaluated by the
Age: median 51- authors
70y,
Men:75%
10/100,000
N. 2; PD 100%
Age/men: NA
229 patients with PD
UK Parkinson’s Disease
NA
including 163 whites (71%), Society Brain Bank diagnostic
N: 229; PD 100% Mutation in the Parkin gene
Age (at onset): 54y Homozygous or compound
1
Ekenze [40], 2010 Nigeria
Hospital
Owolabi [108],
2010
Nigeria
Hospital
Okubadejo [109], Nigeria
2004
Hospital
Okubadejo [110], Nigeria
2005
Hospital
Okubadejo [111], Nigeria
2010
Hospital
Keyser [112],
2010
South Africa Hospital
Van Der Merwe
[113], 2012
South Africa Hospital
Femi [114], 2012 Nigeria
Hospital
Cilia [115], 2012 Ghana
Hospital
45 mixed ancestry (20%), 17
blacks (7%) and 4 Indians
(2%)
Cross8440 admission in the
sectional
medical ward; 1249 had
2003-2007 neurological diseases (men
640)
Cross6282 admission in the
sectional
medical ward; 980 had
2005-2007 neurological diseases (men
586)
Case-control 33 participants (men 25,
mean age 60y ) with PD and
33 match controls
criteria
Not specified
(17-80)
Men: % NA
21.9/1000 of al neurological N: 14
admissions
Age>70 y (71%)
Men: 28.6%
Clinical: any 3 out of tremor, 4.1/1000 of all neurological
rigidity,
admissions
Akinesia/bradikinesia/postural
and instability
Clinical: any 3 out of tremor, NA
rigidity,
Akinesia/bradikinesia/postural
and instability
Case-control 28 participants (men 21,
Clinical: Any 2 out of tremor, NA
mean age 63y ) with PD and rigidity,
28 match controls
Akinesia/bradikinesia/postural
and instability, exclusion of
other causes of parkinsonism
Prospective 124 participants with
Clinical: Any 3 of the
1.5% of all neurological
1996-2006 Parkinsonism including 24 following: tremors, rigidity, consultations
between 01-2005 and 12bradykinesia, and postural or
2006
gait abnormality
Cross154 patients with PD
UK Parkinson’s Disease
NA
sectional
including 51 whites (35%), Society Brain Bank diagnostic
45 Afrikaners (31%), 29
criteria
mixed ancestry (20%), 17
blacks (12%) and 3 Indians
(2%).
Crosssectional
2007-2011
Crosssectional
2007-2011
111 patients with early onset
PD (men 71) and 286 with
late onset PD (men 62%)
1153 participants in 2
Neurologic clinics; 96 (men:
74) had parkinsonism
Case-control 54 participants with PD and
46 healthy participants
heterozygous mutations: 7
patients
Heterozygous variant: 7
UK Parkinson’s Disease
NA
Society Brain Bank diagnostic
criteria
presence of at least three of 6.94% of all neurological
the four cardinal features of consultations
tremors, rigidity,
bradykinesia, and postural or
gait abnormality
UK Parkinson’s Disease
NA
Society Brain Bank Brain
Bank diagnostic criteria
N: 4
Age: (50-68)
Men; 100%
N: 33
Age (at onset): 3680y
Men: 75%
Case fatality rate was higher
in PD (25% vs. 7.1%), Factors
associated with increased
mortality: advanced age and
disease severity
N: 28
Autonomic dysfunction rate
Age (at onset): 37- was higher in PD (61% vs.
76y
6%),
Men: 76%
N: 98; PD 79%
Other causes of parkinsonism
Age (at onset): 61y n(%): Vascular/drug
Men: 76.5%
induced/MSA/LBD:
9(35)/5(19)/4(15)/3(11)
N: 154; PD 100% 16 sequence variants of the
Age (at onset): 52 PINK1gene identified: 1
y
homozygous mutation
Men: 62%
(Y258X), 2 heterozygous
missense variants (P305A
and E476K), and 13
polymorphisms
N: 397; PD 100% A positive family history was
Age (at onset): 57y associated with a younger age
Men: 248
at onse.
N: 96; PD (83.3%)
Age: 58y
Men: 63.5%
N: 54; PD 100% Leucine-rich repeat kinase 2
Age (at onset): 59 (LRRK2) gene found in no
y
participants
Men: 61%
NA: Not available; PD: Parkinson’s disease; UK: United Kingdom; USA: United States of America; y: year
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