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The burden of inpatient neurologic disease in two Ethiopian hospitals

From the Departments of Neurology (J.H.B., P.S.) and Emergency Medicine (S.M.B.), Mayo Clinic College of Medicine; Rochester, MN; the Department of Neurology (M.Z., G.Z.), Addis Ababa University School of Medicine, Addis Ababa, Ethiopia; and the Department of Internal Medicine (J.A.), Gondar College of Medicine and Health Sciences, Gondar, Ethiopia.

Address correspondence and reprint requests to Dr. James H. Bower, Department of Neurology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905; e-mail: bower.james{at}mayo.edu

Objectives: To define the burden of inpatient neurologic disease seen in Ethiopian teaching hospitals.

Methods: We reviewed records of all medical inpatients admitted over a 6-month period to two teaching hospitals, one with and one without neurologists.

Results: Neurologic cases made up 18.0% and 24.7% of all medical admissions. The mortality rates were 21.8% and 34.7%. Noninfectious diseases were 36.7% and 31.7% of neurologic cases, but unknown etiologies made up 42.2% and 29.0% of all cases. Of total cases, only 42.9% and 24.1% had at least a high level of diagnostic certainty.

Conclusions: Patients with neurologic disease make up a substantial minority of medical inpatients in Ethiopia. Noninfectious neurologic disease is at least as common as infectious neurologic disease. Reaching a well-defined final diagnosis occurs in only a minority of cases. Areas for improving the mortality rate include improving the barriers to diagnostic certainty and increasing treatment options for Ethiopian patients.

Editorial, see page 322

See also pages 326 and 384

Disclosure: The authors report no conflicts of interest.

Received July 14, 2006. Accepted in final form November 6, 2006.

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