Electrodiagnostic consultations in Zambia: Referral characteristics and neuromuscular disorders

Michelle Kvalsund; Patrice Mukomena; Takondwa Chidumayo; Gretchen L Birbeck; Michael Andary; Michael Horner; David N Herrmann

doi:10.1016/j.jns.2018.12.003

Electrodiagnostic consultations in Zambia: Referral characteristics and neuromuscular disorders

J Neurol Sci. 2019 Feb 15:397:150-154. doi: 10.1016/j.jns.2018.12.003. Epub 2018 Dec 4.

Authors

Michelle Kvalsund¹, Patrice Mukomena², Takondwa Chidumayo², Gretchen L Birbeck³, Michael Andary⁴, Michael Horner⁵, David N Herrmann⁶

Affiliations

¹ International Neurologic & Psychiatric Epidemiology Program, Department of Neurology & Ophthalmology, Michigan State University, 909 Fee Road, West Fee Hall Room 324, East Lansing, MI 48824, USA; Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia, Nationalist Road, P.O. Box 50110, Lusaka, Zambia. Electronic address: [email protected].
² Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia, Nationalist Road, P.O. Box 50110, Lusaka, Zambia.
³ Department of Neurology, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, USA; UTH Neurology Research Office, Nationalist Road, Paediatric Annex, PO Box UTH 11, Lusaka, Zambia.
⁴ Department of Physical Medicine & Rehabilitation, Michigan State University College of Osteopathic Medicine, 909 Fee Road, Suite B 401 West Fee Hall, East Lansing, MI 48824, USA.
⁵ Panorama Orthopedics & Spine Center, Golden, CO, USA.
⁶ Department of Neurology, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, USA.

PMID: 30634131
DOI: 10.1016/j.jns.2018.12.003

Abstract

Introduction: Research on neuromuscular disorders in sub-Saharan Africa is scarce. We aimed to delineate referral characteristics and the neuromuscular disorders observed among electrodiagnostic (EDX) consultations in a tertiary care setting in Zambia.

Methods: EDX records were reviewed for all specialist-performed studies after the establishment of the laboratory. The frequency of demographic, medical characteristics, and final EDX impressions are presented.

Results: Among 108 referrals, 52% were male, 84% were adults (mean age 44 years). Referrals were predominantly outpatients (85%) and sent by neurologists (68%). HIV infection was common (12%). Diabetes was rare (3%). Overall, 77% of studies were abnormal. Polyneuropathy was the most common abnormal EDX finding, followed by motor neuron disease.

Discussion: A diverse range of neuromuscular diseases was evaluated among EDX referrals in Zambia. Though labor and expertise intensive, access to EDX consultation can enhance clinical care and facilitate research and surveillance of neuromuscular disorders in the region.

Keywords: Africa; Electrodiagnosis; Electromyography; Neurodiagnostics; Neuromuscular disease.

MeSH terms

Adult
Electrodiagnosis*
Female
Humans
Male
Middle Aged
Neuromuscular Diseases / diagnosis*
Outpatients
Referral and Consultation*
Zambia