Clinical series of Parkinson's disease in KwaZulu-Natal, South Africa: Retrospective chart review

  • Ferzana Hassan Amod
    Correspondence
    Corresponding author at: Inkosi Albert Luthuli Central Hospital, 800 Vusi Mzimela Road, Cato Manor, Durban 4091, South Africa.
    Affiliations
    Department of Neurology, Inkosi Albert Luthuli Central Hospital, Cato Manor, Durban, South Africa

    Department of Neurology, University of KwaZulu-Natal, Durban, South Africa
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  • Ahmed Iqbal Bhigjee
    Affiliations
    Department of Neurology, Inkosi Albert Luthuli Central Hospital, Cato Manor, Durban, South Africa

    Department of Neurology, University of KwaZulu-Natal, Durban, South Africa
    Search for articles by this author
Published:March 26, 2019DOI:https://doi.org/10.1016/j.jns.2019.03.023

      Highlights

      • 414 patients met the criteria for PD.
      • 194 were Indian, 130 Black, 16 Mixed Ancestry and 74 White.
      • The median AAO was 60 years, 53% were male, 20% of the cohort had EOPD.
      • Dyskinesias were more frequent in Indian and White patients.
      • Neuropsychiatric symptoms were more frequently in Indian and White patients.

      Abstract

      Background

      There is limited data on Parkinson's disease (PD) in South Africa.

      Methods

      Demographic and clinical information was extracted from the hospital records of patients who were coded as PD (International Classification of Diseases, 10th revision, G20) from 2002 to 2016.PD was diagnosed using the United Kingdom Parkinson's Disease Society Brain Bank Clinical Diagnostic Criteria (UKBBC).

      Results

      414 patients met the criteria, 194 Indian, 130 Black, 16 Mixed Ancestry and 74 White patients. Median age at onset was 60 years, 53% were male and 20% had early onset PD (EOPD). There were no differences between the ethnic groups for the male: female ratio, age at onset, frequency of EOPD, family history, clinical phenotype and disease severity. Dyskinesia and neuropsychiatric symptoms were more frequent in Indian and White patients (p < 0.001). PD referral centre prevalence was 23/1000 neurological cases for the period 2002–2016. Referral centre prevalence of PD was 2.8 times higher in White compared to Black patients. Our study demonstrates an increase in referral centre prevalence of PD since the last clinical series in 1988 and an age related increase in prevalence.

      Conclusions

      PD prevalence is increasing. The clinical profile of PD in Black patients is similar to the other ethnic groups. This study highlights the need for health care resource allocation to neurodegenerative disorders in an ageing African continent.

      Keywords

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