Kim, Curi

School of Public Health

MSPH

Zambia

Epidemiology of Neurologic Disease in Zambia

Neurologic disorders were the leading cause of disability-adjusted life-years and the second leading cause of death worldwide in 2015. While these disorders disproportionately affect low and middle income countries, detailed epidemiology of neurologic disease in these countries is relatively unknown, particularly in sub-Saharan Africa where most countries have few or no neurologists. For example, recent meta-analyses concluded that little is known about the burden of non-compressive myelopathies and neuro-syphilis in Africa, although neither of these disorders are uncommon. Furthermore, systems of care for common neurologic disorders, including stroke, have not been well studied in sub-Saharan Africa despite the growing burden of these disorders in this region.

Zambia is a low-income country in southern Africa. We recently started the first adult neurology inpatient service in Zambia at the University Teaching Hospital (UTH), which is the national referral hospital. The inpatient service is currently staffed full-time by US- and European-trained neurologists who serve as teaching faculty for post-graduate Zambian neurology trainees, and we average 40-60 patients on the service at any time. We are developing an inpatient registry of all patients on the neurology service at UTH and their inpatient, 30-day and 90-day functional outcomes and mortality rates. This information can then be used to improve inpatient and post-discharge systems of care, standardize diagnostic and treatment algorithms for common neurologic disorders, and provide preliminary data for subsequent grants in a variety of neurologic diseases.

Aims
1.) Describe the epidemiology of inpatient neurologic disease at the University Teaching Hospital in Zambia
2.) Determine inpatient, 30-day and 90-day post-discharge morbidity and mortality associated with neurologic disease in Zambia
3.) Determine demographic and clinical risk factors for mortality and poor functional outcome during inpatient hospitalization and at 30 days and 90 days post-discharge in patients with neurologic disorders in Zambia
 

PI Mentor: Deanna Saylor

People

Caitlin Kennedy, PhD MPH,BA

Co-Director, MPH concentration in Social and Behavioral Sciences in Public Health; Associate Director, Center for Qualitative...

Noreen Hynes, MD MPH

Director, Geographic Medicine Center of the Division of Infectious Diseases

Robert Bollinger Jr., MD MPH

Director, Johns Hopkins Center for Clinical Global Health Education (CCGHE); Associate Director, Johns Hopkins Center for Global...

Yukari C. Manabe, MD

Associate Director of Global Health Research and Innovation

Joanne Katz, ScD MS,BSc

Associate Chair, Director of Academic Programs

Stefan Baral, MD MPH,MBA,MSc

Director, Key Populations Program
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May 2019

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