In Her Lifetime Female Morbidity and Mortality in Sub-Saharan Africa (1996) / Chapter Skim
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5 Nervous System Disorders
5 Nervous System Disorders
Pages 123-135
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From page 123... ...
. As noted above, this chapter focuses on the following nervous system disorders for which African females appear to be particularly susceptible or at risk: toxic and nutritional disorders, headache syndromes, cerebrovascular diseases associated with use of oral contraceptives, epilepsies, demyelinating diseases, necrologic complications of collagen diseases, and impaired cognition and dementia.
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From page 124... ...
It is now well established that periconceptional folate supplementation could prevent first occurrence of neural tube defects (Czeizel and Dudas, 1992; MRC Vitamin Study Research Group, 1991~. There is also greater need for folate in subjects with chronic hemolytic disease, such as hemoglobin sickle-cell disease, which afflicts about 1 percent of the West African population, and malaria.
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From page 125... ...
Cerebrovascular disease Migraine Nutritional and toxic myeloneuropathies and peripheral nerve disorders Epilepsies Spinal cord and spinal nerve root disorders secondary to osteodegenerative disease of vertebral column Brain and spinal cord neoplasms (primary and secondary) Head injuries Polymyalgia rheumatica, temporal arteritis Cerebrovascular disease Spinal cord and spinal nerve r`>ot disorders secondary to osteodegenerative disease of the vertebral column (spine)
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From page 126... ...
Use of oral contraceptives also contributes to pyridoxine deficiency and may increase existing nutritionrelated deficits (Stamp, 19939. In some parts of Africa, endemic cretinism is widespread and is the result of iodine deficiency, further conditioned by a cassava diet.
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From page 127... ...
Since the mid-1960s, a vast amount of epidemiologic, clinical, and laboratory evidence in developed countries has linked the current use of combined oral contraceptives with certain types of cardiovascular disease (CVD) , especially venous thromboembolism, thrombotic stroke, myocardial infarction, subarachnoid hemorrhage, and hypertension (Irey et al., 1978; Lancer, 1979; Stadel, 1981; Thor~ood et al.' 1981; Vessey.
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From page 128... ...
Among Caucasians in most published series, males have been affected more often than females by multiple sclerosis, but the disease often begins earlier and runs a more rapid course in females (Acheson, 1972~. Neurologic Complications of Collagen Diseases Collagen diseases appear to be relatively uncommon in black Africans, among whom the prevalence of autoimmune disorders is lower than in Caucasians; polymyositis/dermatomyositis, whether idiopathic or secondary to an underlying neoplasm (which may be occultJ, is the third most common disease of muscles after pyomyositis and the muscular dystrophies in black Africans.
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From page 129... ...
Data from the few well-conducted neuroepidemiologic studies in the region emphasize the great disability and mortality from disorders of the nervous system that will be experienced by African females during their lifetime, and these, in combination with the other evidence presented in this chapter, suggest that the burden of neuropsychiatric disorders is probably heavier in African communities than in other parts of the world. Table 5-4 presents the times in the life span when the major nervous system disorders discussed in this chapter occur in Sub-Saharan African females.
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From page 130... ...
(age 45+ Toxic and nutritional disorders Toxic and nutritional disorders Toxic and nutritional disorders Headache syndromes Toxic and nutritional disorders Headache syndromes Toxic and nutritional disorders Oral contraceptive- Oral contraceptive relate<1 cerebrovascular related cerebro diseases vascular diseases Epilepsies Epilepsies Epilepsies Demyelinating diseases Neurologic complications of collagen diseases Dementias require elucidation. Research attention should be directed toward identification of major risk factors for the more important nervous system disorders in females and development of cost-effective strategies for disease prevention.
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From page 131... ...
1991. A missense mutation in the amyloid precursor protein gene segregates with familial Alzheimer's disease caused by mutations at codon 717 of the betramyloid precursor protein gene.
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1991. A missense mutation in the amyloid precursor protein gene segregates with familial Alzheimer's disease.
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From page 133... ...
1991. Prevention of neural tube defects: results of the Medical Research Council Vitamin Study.
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1989. Influences on the CHD incidence and case fatality: medical management of risk factors.
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1992. Cassava cyanogens and Konzo: an upper motor neurone disease found in Zaire.
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