A door-to-door survey to estimate the prevalence of Parkinsonism in Pakistan

Suliman Khan, Ghulam Nabi, Muhammad Naeem, Liaqat Ali, Peter A Silburn, George D Mellick, Suliman Khan, Ghulam Nabi, Muhammad Naeem, Liaqat Ali, Peter A Silburn, George D Mellick

Abstract

Introduction: Parkinson's disease (PD) occurs in all races and cultures, and population-related differences in frequency may provide etiological clues. The present study was designed to explore the prevalence of PD and Parkinsonism in Pakistan, the world's sixth most populous country, for which no published prevalence data are available.

Methods: We conducted a three-phase door-to-door survey in two districts of the Khyber Pakhtunkhwa province of Pakistan, to assess the prevalence of PD and Parkinsonism in a sample of 4,000 individuals aged 50 years and above.

Results: We identified 14 cases of Parkinsonism, eleven with a diagnosis of idiopathic PD. The overall prevalence estimates were 1.7/100 (95% confidence interval [CI]: 0.9-2.46) for Parkinsonism and 1.28/100 (95% CI: 0.6-1.94) for PD in persons aged 65 years and above. The age-standardized prevalence of PD (aged 65 years and above), normalized to the USA population in 2000, was 1.33/100, which is similar to that observed in other human populations. Of the total 14 cases, five were newly diagnosed and four had a family history of PD.

Conclusion: The estimated prevalence rates in Pakistan are similar to those observed in other human populations. The frequency of familial Parkinsonism is also equivalent to previous estimates.

Keywords: Parkinsonism; Parkinson’s disease; door-to-door survey.

Figures

Figure 1
Figure 1
The age-specific prevalence of iPD in Pakistan as assessed by our door-to-door survey. Abbreviation: iPD, idiopathic Parkinson’s disease.
Figure 2
Figure 2
Parkinsonism and self-reported non-Parkinsonism complications.
Figure 3
Figure 3
hospital-based healthy individuals’ responses to each question in the screening instrument.

References

    1. Pringsheim T, Jette N, Frolkis A, Steeves TD. The prevalence of Parkinson’s disease: a systematic review and meta-analysis. Mov Disord. 2014;29(13):1583–1590.
    1. Zhang ZX, Roman GC, Hong Z, et al. Parkinson’s disease in China: prevalence in Beijing, Xian, and Shanghai. Lancet. 2005;3(9459):595–597.
    1. Fereshtehnejad S, Shafeesabet M, Rahmani A, Delbari A, Lokk J. Medium-to-high prevalence of screening-detected Parkinsonism in the urban area of Tehran, Iran: data from a community-based door-to-door study. Neuropsychiatr Dis Treat. 2015;11:321–332.
    1. Benito-Leon J, Bermejo-Pareja F, Rodriguez J, Molina J, Gabriel R, Morales J. Prevalence of PD and other types of Parkinsonism in three elderly populations of central Spain. Mov Disord. 2003;18(3):267–274.
    1. Hoodfar E, Teebi A. Genetic referrals of Middle Eastern origin in a western city: inbreeding and disease profile. J Med Genet. 1996;33(3):212–215.
    1. National Institute of Population Studies (NIPS) Pakistan Demographic and Health Survey 2006–2007. Islamabad, Pakistan: Pakistan and Macro International Inc; 2008.
    1. Bureau of Statistic, Government of Khyber Pakhtunkhwa, Demographic Data 2014 Government of Khyber Pakhtunkhwa Pakistan Report. 2014. pp. 267–271. Available from:
    1. Rocca WA, Maraganore DM, McDonnell SK, Schaid DJ. Validation of a telephone questionnaire for Parkinson’s disease. J Clin Epidemiol. 1998;51(6):517–523.
    1. Melcon MO, Anderson DW, Vergara RH, Rocca WA. Prevalence of Parkinson’s disease in Junin, Buenos Aires Province, Argentina. Mov Disord. 1997;12(2):197–205.
    1. Ogura C, Nakamoto H, Uema T, Yamamoto K, Yonemori T, Yoshimura T. Prevalence of senile dementia in Okinawa, Japan. Int J Epidemiol. 1995;24(2):373–380.
    1. Bergareche A, De La Puente E, López de Munain A, et al. Prevalence of Parkinson’s disease and other types of Parkinsonism. A door-to-door survey in Bidasoa, Spain. J Neurol. 2004;251(3):340–345.
    1. Kimura H, Kurimura M, Wada M, et al. Female preponderance of Parkinson’s disease in Japan. Neuroepidemiology. 2002;21(6):292–296.
    1. Harada H, Nishikawa S, Takahashi K. Epidemiology of Parkinson’s disease in a Japanese city. Arch Neurol. 1983;40(3):151–154.
    1. Li SC, Schoenberg BS, Wang CC, et al. A prevalence survey of Parkinson’s disease and other movement disorders in the People’s Republic of China. Arch Neurol. 1985;42(7):655–657.
    1. Wang YS, Shi YM, Wu ZY, He YX, Zhang BZ. Parkinson’s disease in China. Coordinational group of neuroepidemiology, PLA. Chin Med J (Engl) 1991;104(11):960–964.
    1. de Rijk MC, Tzourio C, Breteler MM, et al. Prevalence of Parkinsonism and Parkinson’s disease in Europe: the EUROPARKINSON collaborative study. European community concerted action on the epidemiology of Parkinson’s disease. J Neurol Neurosurg Psychiatry. 1997;62(1):10–15.
    1. Hofman A, Collette H, Bartelds A. Incidence and risk factors of Parkinson’s disease in the Netherlands. Neuroepidemiology. 1989;8(6):296–299.
    1. Duarte J, Claveria L, De Pedro-Cuesta J, Sempere A, Coria F, Calne D. Screening Parkinson’s disease: a validated questionnaire of high specificity and sensitivity. Mov Disord. 1995;10(5):643–649.
    1. Kis B, Schrag A, Ben-Shlomo Y, et al. Novel three-stage ascertainment method prevalence of PD and Parkinsonism in South Tyrol, Italy. Neurology. 2002;58(12):1820–1825.
    1. Bower J, Maraganore D, McDonnell S, Rocca W. Infuence of strict, intermediate, and broad diagnostic criteria on the age- and sex-specific incidence of Parkinson’s disease. Mov Disord. 2000;15(5):819–825.
    1. Hussain R, Bittles A. The prevalence and demographic characteristics of consanguineous marriages in Pakistan. J Biosoc Sci. 1998;30(02):261–275.
    1. Sellbach AN, Boyle RS, Silburn PA, Mellick GD. Parkinson’s disease and family history. Parkinsonism Relat Disord. 2006;12(7):399–409.

Source: PubMed

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