Neurophobia in Africa: Survey responses from fifteen African countries

Objective: To assess the prevalence of “neurophobia,” or fear of the neurosciences and neurology, and perceptions of neurology education among medical trainees in African countries. Background: Perceptions of neurology and characterization of neurophobia have been studied among medical trainees around the world. However, few studies on neurophobia have been conducted in African countries despite having a disproportionately high burden of neurological disease and fewer neurologists per capita than all other world regions. Design/Methods: We conducted a cross-sectional survey of medical students and post-graduate trainees in internal medicine and pediatrics across Africa. A 23-item online survey containing multiple-choice, Likert-scale, and free-response questions was adapted from prior literature, translated into English and French, and distributed through listservs and social media. Results: 294 surveys were completed by 197 medical students and 97 post-graduate trainees from 15 countries, with the greatest representation from Zambia (n = 110), Nigeria (n = 54) and Kenya (n = 35). One-fifth of respondents endorsed interest in a future career in neurology while 36% reported discomfort with neurology and almost one-third endorsed neurophobia. Participants rated neurology as the most difficult compared to six other medical subspecialties (p < 0.001) and rated their confidence managing patients with neurological complaints lower than other medical subspecialties except rheumatology (p < 0.005). Conclusions: Medical trainees in multiple African countries endorse fear and discomfort with the subject of neurology. Strategies to mitigate neurophobia, including investments in neurological educational, diagnostic and treatment capacity, are needed to increase the number of medical trainees pursuing careers in neurology.