Neurological disorders and endemic goiter: comparative analysis of 2 provinces in Togo

Neurological diseases are one of the main causes of high mortality and morbidity in developing countries. The prevention of these diseases is possible if they are well known. The purpose of this study was to evaluate the prevalence and the distribution of the main neurological affections in two rural districts. WHO research protocol for measuring the prevalence of neurological disorders in developing countries was used by the same staff. The first survey was conducted in Kloto from July to August 1989 on 19,241 inhabitants and the second in Akébou from January to February 1995 on 4182 subjects. Akébou was known as endemic goiter district. The prevalence of epilepsy was 12.3@1000 in Kloto and 13.1@1000 in Akébou. That of stroke was 2.4@1000 in Kloto versus 1.7@1000 in Akébou. The prevalence of Parkinson's disease was 0.2@1000 in Kloto and 0.2@1000 in Akébou. That of psychomotor retardation was 3.2@1000 in Kloto versus 8.1@1000 in Akébou. The prevalence of neurological cretinism was 97@1000 while that of myxoedematous cretinism was 31@1000 in Akébou. Apart from neurological disease, the prevalence of goitre was 43% in females and 26.1% in males in Akébou. Mental retardation and cretinism were frequent in Akébou, a district endemic for goitre. Besides stroke and febrile convulsions which predominated in Kloto, the main neurological disorders were most prevalent in Akébou. Community based care for epilepsy is provided in these districts as is the prevention of iodine deficiency in the Akébou district with the intention of reducing neurological affections.