Abstract
Introduction
Parkinson’s disease (PD) is the second most common neurodegenerative condition globally. Its cardinal motor signs are bradykinesia, rest tremor, rigidity, and postural instability. The motor symptoms of PD often lead to dependence on others to perform daily activities. Globally, the incidence of PD is rising. However, for countries in sub-Saharan-Africa such as Tanzania, research on the motor aspects of PD and the associated disability is sparse. The primary aim of this study was to determine the motor symptoms, and burden of motor symptoms, in newly diagnosed people with idiopathic PD (IPD) in the Hai district of Tanzania. The secondary aim was to ascertain the level of disability amongst this group.
Methods
A questionnaire was completed by households in Hai to screen individuals for the cardinal symptoms of PD. Positive responders were assessed for symptoms of PD in their community and, as necessary, were diagnosed by a neurologist. The Movement Disorder Society-Unified Parkinson’s Disease Rating Scale was used to measure the frequency and severity of each motor symptom. Additionally, the total score was used to represent the burden of motor symptoms. PD was staged using the Hoehn and Yahr scale and the Barthel Index was used to measure disability. To classify the scores, validated cut-off values were used.
Results
Thirty-one individuals with idiopathic PD were identified. Of these, twenty-one participants were newly diagnosed and not taking PD medication during data collection. The burden of motor symptoms amongst participants was classified as severe, and the most common motor subtype was tremor-dominant PD. Seventeen participants demonstrated a moderate or severe level of disability.
Conclusions
Motor burden and disability were prevalent amongst newly diagnosed people with idiopathic PD in Hai. Despite trends, definitive conclusions on the total burden of motor signs and level of disability were limited by incomplete data and recruitment issues.
Comments
Very interesting work!
Can I ask whether those newly diagnosis with PD have reliable access to PD medications? And if there is provision for follow-up? Seems there must be some access to medications, as you mention several patients began taking medication before data collection...
Interesting
Very interesting work.
Do you think that the biggest proportion of patients having tremor predominant PD is related to them being more likely to present to this service? (given that this is the symptom that people most associate with PD).
Interesting project! Just…
Interesting project! Just out of interest, did the team visit Tanzania to carry out this work? How did you identify patients living with Parkinson’s disease in the villages, particularly those who were medication-naïve? I assume they did not have an official PD diagnosis prior to your visit?