Neurological Morbidity and Mortality in a Neurological Low-Resource Setting: A 2-Year Audit of a Nigerian Hospital

There is still a paucity of information on the burden of neurological disorders particularly in low-resource settings such as sub-Saharan Africa. The objective of this study was to report the burden of neurological disorders, including morbidity and mortality, in adult patients at a Northwestern Nigerian tertiary hospital over a 2-year period.

An audit of adult medical admissions from July 1, 2015, to June 30, 2017, was conducted. Anonymized data on medical admissions were retrieved from admission registries. Primary and secondary outcomes of interest were neurological diagnoses and clinical outcomes, respectively. The Pearson χ and independent t tests were used to test for differences between neurological and general medical proportions and outcomes with a 5% significance level set.

Over the 2-year period, 2772 adults were admitted. Neurological morbidity comprised almost a 10th of all adult medical admissions (9.1%), whereas neurological mortality accounted for more than a fifth of all deaths (22.2%). Stroke was the leading cause of neurological morbidity (62.9%) and mortality (79.8%). Infections of the nervous system and epilepsy were other frequent causes of neurological morbidity. Outcomes were poorer for neurological patients (fatality rates: neurological, 55.5%; medical, 19.5%, P<0.001).

Neurological disorders were a significant cause of adult medical morbidity and, to a greater extent, of mortality. Cerebrovascular disease and infections of the nervous system were major drivers of mortality. Cost-effective strategies appropriate for low-resource settings are required to prevent and reverse these negative outcomes.