Yield of training exchanges between Europe and Sub-Saharan Africa

Opportunities that allow neurologists-in-training from Western Europe and Sub-Saharan Africa to benefit from exchanges between their respective neurological departments are rare. In a pilot exchange program, we compare the patterns of neurological diseases encountered in neurological wards of public hospitals in Brussels and Yaoundé to underline educational benefits. For 5 months the age, sex, mortality, HIV cases and clinical characteristics of admitted patients were prospectively analyzed. Eighty Cameroonian and 105 Belgian patients were classified into the following neurological entities: infectious, vascular, immune-related, epileptic, degenerative, neoplastic, psychogenic and movement disorders. Means and proportions were compared using Student's test and Fisher's exact test, respectively. Patients were younger in Yaoundé (mean age 45. 3 vs. 54. 0 years, p = 0. 002), but died four times more (23. 75 vs. 4. 75 % of admissions, p < 0. 001). HIV proportion was 43. 75 % in Yaoundé and nil in Brussels. Infectious complications were responsible for 100 % of deaths in HIV-positive patients against 44 % in HIV-negative patients (p = 0. 0108). The proportions of vascular, neoplastic and movement disorders were comparable. Neurological complications of infections occurred ten times more in Yaoundé (69 vs. 6. 7 %, p < 0. 0001). Multiple sclerosis accounted for 11. 4 % of admissions in Brussels but other immune-related diseases were more frequent in Yaoundé (8. 75 vs. 2 %, p = 0. 04). Epileptic, degenerative and psychogenic diseases were more frequent in Brussels: 38. 1 versus 12. 5 % (p < 0. 001), 16. 2 versus 5 % (p < 0. 0194) and 3. 75 versus 14. 3 % (p < 0. 0224), respectively. Exchanges between Western Europe and Sub-Saharan neurological wards could offer neurologists-in-training firsthand experience with diseases seldom met; otherwise, an understanding of different healthcare systems and a better understanding of the concept of neurology as a public health challenge. © 2012 Belgian Neurological Society.