Table 1 Overview of studies on Parkinsonism and risk factors in sub-Saharan African countries

Bower [10], 2005

Ethiopia

Hospital

Cross-sectional 2003-2004

720 patients; 109 (15 · 1%) with movement disorders including 71 men; age 52 y. (13–80)

Not provided

72/1,000 of all admissions (PD: 64/1,000)

N:52; PD:88%

Review of medical files/outpatient neurology clinic.

Age (at onset): 57y (30–80)

Men: 75%

Akinyemi [11], 2008

Nigeria

Hospital

Case–control 2005-2005

51 patients (men 37) with PD and 50 controls

UKPDS Brain Bank criteria

NA

N:51; PD: 100%

22% patients with PD had cognitive dysfunction, with age at PD onset as sole predictor of cognitive dysfunction.

Age (at onset): 70y (41–80)

Men:72%

Cosnett [12], 1988

South Africa

Hospital

Cross-sectional 1979-1985

2638 patients

Clinical (Bradykinesia, rigidity, resting tremor and postural instability)

5.3/1,000

N:14; PD: 100%

Retrospective review of medical files/outpatient clinic

Age: NA

Blacks: 1.5/1000

Men: NA

Indians: 12.6/1000

Whites: 23.1/1000

Dotchin [13], 2008

Tanzania

Community

Cross-sectional

161,071 inhabitants

UKPDS Brain Bank criteria

Overall: 40/100,000

N: 32; PD:100%

Prevalence is adjusted to UK population. Mean duration 5.1 y

Men: 64/100,000

women: 20/100,000

Age (at onset): 69y (29–90)

Men: 72%

Schoenberg [14], 1988

Nigeria

Community

Cross-sectional

Black population aged 40 + 3412 participants

Clinical

Age adjusted: 67/100,000

N: 2; PD:100%

Age: NA

Men: NA

USA

Community

Cross-sectional

Black population aged 40 + 3521 black participants and 5404 white participants.

Clinical

Age adjusted:

N: 12; PD: 100%

Age: NA

Blacks: 341/100,000

Men: NA

Whites: 352/100,000

Winkler [15], 2010

Tanzania

Hospital

Cross-sectional

n = 8676 patients admitted (740 with neurological diseases)

UKPDS Brain Bank criteria

1/1,000 (all patients)

N: 8; PD:37%

2003

11/1,000 (Patients with neurological diseases

Age: ≥32 y

Men: 100%

Community

Cross-sectional

1569 people, age 50–110 years

UKPDS Brain Bank criteria

235/100,000

N: 0

None of the 18 screened-positive was confirmed as having PD. Poisson distribution used to estimate the prevalence.

2003-2005

Kengne [16], 2006

Cameroon

Hospital

Cross-sectional

4041 patients in a neurology clinic145 (3.9%) had neurodegenerative diseases

Not provided

488/1,000 of all neurodegenerative diseases; 10.1/1,000 of all neurologic consultation

N: 41; PD 100%

4 selected neurodegenerative brain disorders: dementia, PD, ALS, chorea

1993-2001

Age: 15-84 y

Men: 73.2%

Lombard [17],1978

Zimbabwe

Hospital

Cross-sectional

Total patients admitted: 83,453 blacks, 34,952 whites

Not provided

Blacks: 0.21/1,000

N: 50 (17 blacks)

Retrospective review of medical files

Whites: 2.83/1,000

Age/men: NA

Osuntokun [18], 1979

Nigeria

Hospital

Cross-sectional

217 patients with parkinsonism

Not provided

NA

N: 217; PD 38%

All patients evaluated by the authors

1966-1976

Age: median 51-70 y,

Men:75%

Osuntokun [19], 1987

Nigeria

Community

Cross-sectional

Total participants surveyed: 18,954

Not provided

10/100,000

N. 2; PD 100%

Screening Questionnaire developed by author

1985

Age/men: NA

Haylett [20], 2012

South Africa

Hospital

Cross-sectional

229 patients with PD including 163 whites (71%), 45 mixed ancestry (20%), 17 blacks (7%) and 4 Indians (2%)

UKPDS Brain Bank criteria

NA

N: 229; PD 100%

Mutation in the Parkin gene

Age (at onset): 54 y (17–80)

Homozygous or compound heterozygous mutations: 7 patients

Heterozygous variant: 7

Men: % NA

Ekenze [21], 2010

Nigeria

Hospital

Cross-sectional

8440 admission in the medical ward; 1249 had neurological diseases (men 640)

Not specified

21.9/1000 of al neurological admissions

N: 14

2003-2007

Age ≥ 70 y (71%)

Men: 28.6%

Owolabi [22], 2010

Nigeria

Hospital

Cross-sectional

6282 admission in the medical ward; 980 had neurological diseases (men 586)

Clinical: any 3 out of tremor, rigidity, Akinesia/bradikinesia/postural and instability

4.1/1,000 of all neurological admissions

N: 4

2005-2007

Age: (50–68)

Men; 100%

Okubadejo [23], 2004

Nigeria

Hospital

Case–control

33 participants (men 25, mean age 60 y) with PD and 33 match controls

Any 3 out of tremor, rigidity, Akinesia/bradikinesia/postural and instability

NA

N: 33

Case fatality rate was higher in PD (25% vs. 7.1%), Factors associated with increased mortality: advanced age and disease severity

Age (at onset): 36-80y

Men: 75%

Okubadejo [24], 2005

Nigeria

Hospital

Case–control

28 participants (men 21, mean age 63 y) with PD and 28 match controls

Any 2 out of tremor, rigidity, Akinesia/bradikinesia/postural and instability, exclusion of other causes of parkinsonism

NA

N: 28; PD 100%

Autonomic dysfunction rate was higher in PD (61% vs. 6%),

Age (at onset): 37-76 y

Men: 76%

Okubadejo [25], 2010

Nigeria

Hospital

Cross-sectional

124 participants with Parkinsonism in a neurology clinic

Any 3 of the following: tremors, rigidity, bradykinesia, and postural or gait abnormality

15/1,000 of all neurological consultations

N: 98; PD 79%

Other causes of parkinsonism n(%): Vascular/drug induced/MSA/LBD: 9(35)/5(19)/4(15)/3(11)

1996-2006

Age (at onset): 61y Men: 76.5%

Keyser [26], 2010

South Africa

Hospital

Cross-sectional

154 patients with PD including 51 whites (35%), 45 Afrikaners (31%), 29 mixed ancestry (20%), 17 blacks (12%) and 3 Indians (2%).

UK Parkinson’s Disease UKPDS Brain Bank criteria

NA

N: 154; PD 100%

16 sequence variants of the PINK1gene identified: 1 homozygous mutation (Y258X), 2 heterozygous missense variants (P305A and E476K), and 13 polymorphisms

Age (at onset): 52 y

Men: 62%

Van Der Merwe [27], 2012

South Africa

Hospital

Cross-sectional

111 patients with early onset PD (men 71) and 286 with late onset PD (men 62%) from a movement disorder clinic

UKPDS Brain Bank criteria

NA

N: 397; PD 100%

A positive family history was associated with a younger age at onset.

2007-2011

Age (at onset): 57 y Men: 248

Femi [28], 2012

Nigeria

Hospital

Cross-sectional

1153 participants in 2 Neurologic clinics; 96 (men: 74) had parkinsonism

presence of at least three of the four cardinal features of tremors, rigidity, bradykinesia, and postural or gait abnormality

69.4/1,000 of all neurological consultations

N: 96; PD (83.3%)

2007-2011

Age: 58 y

Men: 63.5%

Cilia [29], 2012

Ghana

Hospital

Case–control

54 participants with PD and 46 healthy participants

UKPDS Brain Bank criteria

NA

N: 54; PD 100%

Leucine-rich repeat kinase 2 (LRRK2) gene found in no participants

Age (at onset): 59 y (30–83)

Men: 61%