Determining the burden of neurological disorders in populations living in tropical areas: who would be questioned? Lessons from a Mexican rural community.

BACKGROUND The best approach to determine the burden of neurological disorders in developing countries is to perform population-based studies. Our objectives were to determine the prevalence of neurological disorders in a Mexican rural community and assess the usefulness of a household screening questionnaire. METHODS The survey took place in a Mexican rural community of Puebla State in Mexico. This was a cross-sectional, population-based, 2-phase study including a comparison of the usefulness levels of the individual (IQ) and household (HQ) questionnaires. RESULTS A total of 4,008 individuals participated in the prevalence study using the IQ; of these, 280 neurological examinations allowed to identify 127 individuals suffering from at least 1 neurological disease. The most frequent ailments were headache (22.4/1,000, 95% confidence interval, CI: 17.7-28.2), neuropathy (7.1/1,000, CI 95%: 4.4-11.3) and epilepsy (3.9/1,000, CI 95%: 2.3-6.5). The HQ, used in parallel with the IQ, detected significantly fewer neurological cases. This result was mainly due to the low capacity of the HQ to detect headache. CONCLUSIONS Results of the prevalence study are discussed emphasizing their relevance in adequately allocating resources. The usefulness of the HQ for screening neurological disorders in general was low, but could be adequate for specific neurological disorders.