Chapter
1 Methodological Challenges of Neuroepidemiological Studies in Low- and Middle-Income Countries
1.2 Study design and Feasibility in the Field
1.3.1 Geographical Difficulties
1.3.2 How to Move Forward?
1.3.3 Systematic Review and Meta-Analysis
1.3.4 Socioeconomic and Sociocultural Factors
1.4 Difficulties in the Availability and Mobilization of Data
1.4.2 General Population Census
1.4.3 Cartography and Geographical Information Systems
1.5.1 Geographical and Logistical Challenges
1.5.2 Demographic and Follow-Up Issues
1.6 Clinical and Regulatory Issues
1.6.1 International Ethic Rules
1.6.2 Suspected Cases Ascertainment
1.6.3 Diagnostic and Treatment
1.7 Design-Specific Issues
1.7.1 Cases Census and Sample Studies
1.7.2 Involvement of Institutions and Key Stakeholders
1.7.3 Medical Examinations, Biological Specimens and Laboratory Tests
1.7.4 Monitoring and New Technologies
1.8 Valorization: Scientific and Public Health Issues
1.8.1 International Acknowledgments of the Works Conducted in Tropical Areas
1.8.2 Advocacy—Policy and International Cooperation
II. Tropical Neuroepidemiology: Between Environment and Genetics
2.2 Tropical Neuroepidemiology and Health Anthropology: For Effective Collaboration
2.2.1 The Expected and Assumed Collaborative Epidemiology/Anthropology
2.2.2 A Concept: Almost Exclusive Use of the Sociocultural Representation Theory
2.2.3 Health-Related Stigma
2.3 Mental Disorders and Traditional Beliefs in SSA
2.3.1 Explanatory Models of Mental Illness in SSA
2.3.1.1 What are the Theories of Mankind in SSA?
2.3.1.2 Causality of Mental Illness in SSA
2.3.1.3 Psychosis and Neurosis
2.3.1.4 Stigma and Mental Illness
2.3.1.5 Managing Mental Illness: Traditional or Modern Medicine?
2.4 Sociocultural Representations and Stigma in Epilepsy
2.4.1 Explanatory Models of Epilepsy
2.4.2 Symptomatic Denominations
2.4.3 Etiological Denominations
2.4.4 Beliefs About Epilepsy in SSA
2.4.4.1 Magical Causes (Evil-Spirit, Possession, and Witchcraft)
2.4.4.3 “Biomedical Model”: Foreign Body Migration, Body Fluids-Bound, and Heredity
2.4.4.4 Epilepsy and Stigma
2.5 Sociocultural Representations and Stigma in Dementia
2.5.1 Models of Understanding of Dementia
2.5.2 Social Tolerance of People With Dementia: Representations and Stigma
3 Climatic Factors Under the Tropics
3.2 A Physical Geographic Approach: The Climate and Its Characteristics
3.2.1 The Role of the Inter-Tropical Convergence Zone
3.2.2 Types of Tropical Climate
3.3 A Biogeographical Approach: How Climate’s Features Determine Natural Biomes and Ecosystems
3.3.2 Microbial Diversity and Biogeography
3.4 Biology: Adaptation and Acclimation to Tropical Climates
3.4.3 UVR and Airborne Propagation of Neurotropic Viruses
3.4.4 Thermoregulation in Man
3.5 Does the Tropical Climate Favor Pathogens and Infections in Humans?
3.5.2 Role of Environmental Conditions
3.5.3 Infections of Humans
3.5.4 Seasonality Under the Tropics
3.5.5 The Tropical Origin of Infectious Diseases
3.5.6 Fungal Proliferation Under the Tropics
3.5.7 Algal Blooms and Seafood Poisoning
3.6 Weather Events and Extreme Effects of Climate
3.7 A Health Geographical Approach: Case Studies of Climatic Features that Modulate Tropical Diseases
3.7.1 Mainly Climatic Determinants
3.7.1.1 Epidemic Meningococcal Meningitis
3.7.2 Complex Relations Between Climate, Soil, and Human Activities
3.7.2.1 Climate Impact on Tropical Endemic Diseases Vectors Ecology: Case Studies of Malaria and Human African Trypanosomia...
3.7.2.2 The Amazon Basin, Soil Chemical Composition, Soil–Air Interface, Climate Dependency, and Environmental (Surface Wat...
3.8 The “Boomerang Effect” Under the Tropics: Health Consequences of Anthropogenic Changes
3.8.1 The Bangladesh Story: Persistent Dryness, Safe Drinking Water Availability and Deep-Water Wells
3.8.2 Agriculture Under the Tropics
3.8.3 Perturbation of the Global Nutrient Cycles
3.8.4 Climate in Tropical Cities
4.2 Health System Financing: Key Challenges
4.2.1 The Changing Landscape of Disease and Injury
4.2.2 Health Spending: Inefficient or Insufficient?
4.2.3 Composition of Health Spending
4.3 Economical Aspects Related to Chronic Neurological Diseases
4.3.2 Dementia and Cognitive Disorders
4.3.2.1 The Global Burden of Disease Approach
4.3.2.2 Limitations of the GBD Approach
4.3.2.3 Alternative Approaches to Understanding the Economic Impact of Dementia
5 Tropical Epidemiology: Nutritional Factors
5.2 The Tools for Pointing Out Malnutrition and Obesity and Their Thresholds
5.2.2 Unintentional Loss of Weight
5.2.3 Main Other Anthopometric Assessments
5.3 The Main Causes of Malnutrition During Neurological Diseases and Their Treatment
5.3.3 Swallowing Disorders
5.3.4 Disorders of Salivation
5.3.5 The Increase in Energy Expenditure
5.3.6 The Role of Therapeutics
5.4 Nutrition and Epilepsy in Tropical Countries
5.4.1 Malnutrition or Obesity as Possible Consequences of Epilepsy
5.4.2 Epilepsy Favored by Malnutrition
5.5 Nutrition and Dementia in Tropical Countries
5.5.2 Nutritional Factors Associated With Dementia
5.5.2.1 Malnutrition and Weight Loss
6 Genetics of Infections and Diseases Caused by Human Parasites Affecting the Central Nervous System
III. Tropical Neuroepidemiology by Large Areas of the World
7.2.1 Incidence, Prevalence, and Mortality
7.2.4 Other Causes of Stroke
7.3.1 Prevalence and Incidence
7.3.2 Classification and Causes
7.3.4 Psychosocial Burden
7.3.6 Steven–Johnson Syndrome Secondary to Carbamazepine
7.4.1 Prevalence of Primary Headache
7.4.2 Headache in the Elderly
7.4.3 Cultural Influence on Concepts and Management
7.5.2 Neuromyelitis Optica
7.6 Neuromuscular Disorders
7.6.1 Amyotrophic Lateral Sclerosis
7.6.2 Guillain–Barré Syndrome
7.7.1 Parkinson’s Disease
7.7.2 Atypical Parkinsonian Syndromes
7.7.3 Huntington’s Disease
7.7.4 Other Movement Disorders
7.10.1 Number of Neurologists
7.10.2 Neuroimaging, Clinical Neurophysiology Services, and Pharmaceuticals
7.10.3 Training Programs for Neurologists
7.10.4 Regional Networking and Publication
8 Neurologic Diseases in Tropical Oceania
8.2.2 Geography and Health Resources
8.2.2.1 The Northern Territory
8.2.2.2 Queensland and Far North Queensland
8.2.2.3 The Kimberleys and North Western Australia
8.2.4 Neurology in Tropical Australia
8.2.4.1 Infectious Diseases: Protozoal and Nematode Infections
8.2.4.1.2 Nematode-Induced Myositis
8.2.4.2 Infectious Diseases: Vector-Borne Viral Infections
8.2.4.2.1 Flaviviral Infections
Neurological Features of Flaviviral Infections
Diagnosis of Flaviviral Infection
Epidemiology of Arboviruses
Climate and Animal Vectors and Other Modes of Transmission
8.2.4.2.2 Murray Valley Encephalitis Virus
8.2.4.2.5 Japanese Encephalitis Virus
8.2.4.2.6 Newer Viral Infections Associated With Encephalitis
8.2.4.4 Non-infectious Neurological Diseases
8.2.5 Cerebrovascular Disease
8.2.6 Rheumatic Fever and Rhematic Heart Disease
8.3.1.2 Vector-Borne Viral Disease
8.4.1.1 ALS–Parkinsonism–Dementia Complex
8.6 Cerebrovascular Disease in Oceania Outside Australia
References and Selected Reading
Newer Viral Encephalitides
Murray Valley Encephalitis
9 Neuroepidemiology in Latin America
9.2 Neuroepidemiology in Latin America
9.7 Headache and Migraine
9.8 Extrapyramidal Disease and Parkinson’s Diseases
9.10 Neuroinfectious Diseases
9.11 Neuroepidemiology Training and Education
10 Epidemiology of Neurological Disorders in Sub-Saharan Africa
10.2 Infections of the Nervous System
10.2.1 HIV-Related Neurological Diseases
10.2.5 Tuberculous Spondylitis
10.3 Tropical Spastic Paraparesis
10.7.1 Etiologies of Epilepsy
10.7.1.2 Birth Complications
10.7.1.3 Febrile Convulsions
10.11 Peripheral Neuropathies
10.12 Parkinson’s Disease
IV. Focus on Specific Neurological Syndromes or Diseases in Tropical Areas
11.2.1 Epileptic Seizures
11.3.1 Classification of Epilepsies and Epileptic Syndromes
11.3.2 Classification by Seizure Type
11.3.2.2 Generalized Seizures
11.3.2.2.1 Generalized Convulsive Seizures
11.3.2.2.2 Absence Seizures
11.3.2.2.3 Other Motor Seizures
11.3.2.2.4 Unclassifiable Seizures
11.4.1 Methodological Considerations
11.4.1.1 Difficulties With Identification
11.4.1.3 The Problem of Diagnosis
11.4.2 The Prevalence of Epilepsy
11.4.3 The Incidence of Epilepsy
11.5 The Causes of Epilepsy
11.5.1 Identifying the Etiology
11.5.2.1 Acute Bacterial Meningitis
11.5.2.2 Other Bacterial Suppurative Infections
11.5.2.5 Viral Infections
11.5.2.5.1 Human Immunodeficiency Virus
11.5.3 Traumatic Brain Injury
11.5.5 Cerebrovascular Disease
11.5.7 Family History of Epilepsy
11.8 Sociocultural Aspects
12.1.4 An Aging and Changing World
12.2.2 Latin America and Caribbean
12.2.3 Sub-Saharan Africa
12.3.2 Latin America and the Caribbean
12.3.3 Sub-Saharan Africa
13 Other Neurocognitive Disorders in Tropical Health (Amyotrophic Lateral Sclerosis and Parkinson’s Disease)
13.2 Clinical Features of ALS
13.2.2 Clinical Symptoms and Signs
13.3 Clinical Features of Parkinsonian Disorders
13.3.3 Diagnostic Criteria
13.4.1 Study of ALS in Tropical Areas, a Challenging Context
13.4.2 ALS Variability With Population’s Ancestral Origin
13.4.6 ALS in Latin America
13.5.1 Prevalence of Parkinsonism in Tropical Countries
13.5.2 Hypothesis for the Lower Frequency of PD in Tropical Countries
13.5.2.1 Racial or Ethnic Differences?
13.5.3 Higher Proportion of Atypical Parkinsonism?
13.5.4 Environmental Exposures?
14.2 Burden of Stroke in SSA
14.2.2.4 Stroke Case-Fatality
15 Neuromuscular Disorders in Tropical Areas
15.2.1 Bacterial Infections
15.2.1.5 Tropical Pyomyositis
15.2.1.6 Leptospirosis and Other Spirochetes
15.2.2.1 Human Immunodeficiency Virus
15.2.2.2 The Neurotropic Herpes Viruses
15.2.2.4 Human T-lymphotropic Virus 1
15.2.2.5 The Hepatitis Viruses
15.2.3 Parasitic and Fungal Infections
15.2.3.1 American Trypanosomiasis
15.2.3.2 Trichinellosis (or Trichinosis)
15.2.3.5 Schistosomiasis (or Bilharziasis)
15.2.3.8 Angiostrongyliasis
15.2.3.10 Infection by Haycocknema perplexum
15.2.3.15 Bothriocephalus Infection
15.2.3.18 Microsporidial Infections
15.3 Malnutrition and Micronutrient Deficiencies
15.3.1 Vitamin B1 (Thiamin) Deficiency
15.3.2 Vitamin B2 (Riboflavin) Deficiency
15.3.3 Vitamin B3 (Niacin) Deficiency
15.3.4 Vitamin B5 (Pantothenic Acid) Deficiency
15.3.5 Vitamin B6 (Pyridoxine) Deficiency
15.3.6 Vitamin B8 (Biotin) Deficiency
15.3.7 Vitamin B12 (Cobalamin) Deficiency
15.3.10 Tropical Ataxic Neuropathy
15.4.1 NMDs Caused by Envenimation
15.4.1.4 Marine Poisoning
15.4.1.5 Plant Sources and Other Animal Poisons
15.5.2 Immune-Mediated NMDs
15.5.2.1 Guillain–Barré Syndrome
15.5.2.3 Myasthenia Gravis
15.7 Idiopathic Neuropathies
16 Headaches in Tropical Areas
16.2 Epidemiological Aspects
16.4.3 Secondary Headache
16.4.3.1 Headache of Ophthalmological Origin
16.4.3.2 Headache in Intracranial Infection
16.4.3.3 Work-Related Headache
17 Neuropsychiatric Disorders and Addictions
17.2 Psychiatry and Mental Health in SSA
17.2.1 Epidemiology in Mental Health in SSA
17.2.1.1 Prevalence of Mental Illness and Associated Factors
17.2.1.2 Women’s Mental Health
17.2.1.3 Childhood Mental Health
17.2.1.4 Mental Health in Prisons
17.2.1.5 Consequences of Mental-Health Diseases and Mental Quality of Life
17.2.2 Support for Mental Illness and Promotion of Mental Health
17.2.2.2 Solutions for More Effectively Dealing With Mental Health in SSA
17.3.1 History and Generality of Addictions in SSA
17.3.1.1 The Local Production of Cannabis
17.3.1.2 Local Production of Heroin and Cocaine
17.3.2 Epidemiology of Addictions in SSA
17.3.2.1 Prevalence of Addictions in SSA
17.3.2.1.1 Prevalence of Addiction to Intravenous Drug Misuse in SSA
17.3.2.1.2 Drug Abuse and HIV
17.3.2.2 Specificity of the Addictions in Women in SSA
17.3.2.3 Prevalence of Addictions in Childhood and Adolescents in SSA
17.3.2.4 Factors Associated With Addictions in SSA
17.3.2.4.1 Factors Associated With Smoking in SSA
17.3.2.4.2 Factors Associated With Alcoholism in SSA
17.3.2.4.3 Factors Associated With Intravenous Drug Injection in SSA
17.3.2.4.4 Factors Associated With Addiction in Teenagers in SSA
17.3.2.4.5 Factors Associated With Addictions in Women SSA
17.3.2.5 The Consequences of Addictions in SSA
17.3.2.6 The Causes of Addiction in SSA
17.3.2.6.1 Causes of Alcoholism in SSA
17.3.2.6.2 Causes of the Tobacco Epidemic in Developing Countries
17.3.2.6.3 Causes of Illicit Drug Addiction in SSA
17.3.2.6.4 Causes of Trafficking of Drugs in SSA
17.3.3 Solutions to Addiction in SSA
17.3.3.1 Fighting Tobacco Control in SSA
17.3.3.2 The Fight Against Alcoholism
17.3.3.3 The Fight Against Drug Abuse and Trafficking of Psychotropic Drugs
18 Neurological Syndromes or Diseases Caused by Parasites in Tropical Areas
18.3 American Trypanosomiasis
18.4 African Trypanosomiasis
18.10 Nodding Syndrome and Onchocerciasis
18.11 Neurologic Infections by Free-Living Amebae
19 Bacterial Diseases of the Nervous System
19.2 BM/Encephalitis/Cerebral Abscess (Mycobacteria Excluded)
19.2.1 Neonatal Meningitis
19.2.1.1 Epidemiology and Physiopathology
19.2.2 BM in Children and Adults
19.2.2.1.1 Meningococcal Disease
19.2.2.1.2 Streptococcus pneumoniae
19.2.2.1.3 Other Pathogens
19.2.2.3 Clinical Features
19.2.2.7.1 Chemoprophylaxis
19.3 Mycobacterial Infections
19.3.1.3 Clinical Features
19.3.1.7.1 Chemoprophylaxis
19.3.1.7.2 Vaccination: Bacille Calmette–Guérin
19.3.2.3 Clinical Features
19.4 Other Bacterial Infections Involving the CNS
19.4.1.2 Physiopathology/Microbiology
19.4.1.3 Clinical Features
19.4.2.1 Leptospirosis, Brucellosis and Q Fever
19.4.2.1.2 Physiopathology
19.4.2.1.3 Clinical Features
19.4.3 Mycoplasma pneumoniae
19.4.3.1 Physiopathology162,164 and Diagnosis
19.4.4.4 Outcome in Survivors
20.2 Herpes Simplex 1 and 2
20.2.2 CNS Diseases Caused by HSV
20.2.5 Prevention and Treatment
20.3 Varicella Zoster Virus
20.4.4 Treatment and Prevention
20.5.4 Treatment and Prevention
20.6 Human Herpes Virus 6
20.8.4 Treatment and Prevention
20.9 Non-polio Enteroviruses
20.9.1 Epidemiology and Clinical Features
20.9.3 Treatment and Prevention
20.10 Paramyxoviruses (Measles, Mumps, and Nipah Viruses)
20.10.1.3 Prevention and Treatment
20.10.2.4 Prevention and Treatment
20.10.3.2 Pathogenesis and Pathology
20.10.3.4 Prevention and Treatment
20.11.1 Human T–Lymphotropic Virus
20.11.1.4 Prevention and Treatment
20.11.2 Human Immunodeficiency Virus
20.11.2.4 Prevention and Treatment
20.12 Polyomavirus and Progressive Multifocal Leucoencephalopathy
20.12.4 Prevention and Treatment
20.13 Rhabdoviridae/Lyssavirus
20.13.4 Prevention and Treatment
20.14.1 Bunyaviridae Family
20.14.2 Flaviviridae Family, Genus Flavivirus
20.14.2.2 Clinical Features
20.14.2.4 Prevention and Treatment
20.15 Togaviridae/Rubivirus
20.16 Poxviruses/Smallpox and Vaccinia
20.16.2 Prevention and Safety of the Vaccine
21 Other Diseases: Traumatic Brain Injuries, Tumors, and Multiple Sclerosis
21.1 Traumatic Brain Injuries
21.1.2 Distribution by Age and Sex
21.1.3 The Circumstances of Occurrence
21.1.4 Morbidity and Mortality
21.2.1.1 Endogenous Factors
21.2.1.1.2 Genetic Factors
21.2.1.1.3 Allergic Conditions
21.2.1.1.4 Anthropometric Factors
21.2.1.2 Exogenous Factors
21.2.1.2.1 Ionizing Radiations
21.2.1.2.2 Magnetic Fields
21.2.1.2.3 Viral Infections
21.2.3 Breakdown by Location and Nature of Tumors
Neuroepidemiology in Tropical Health
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