Objective: To describe the knowledge of parkinsonian movement disorders in a sample of Cameroonian health providers and the impact of a basic training course.

Background: There is no available data on epidemiology and management of parkinsonism or Parkinson disease (PD) in Cameroon. Similarly to other sub-Saharan countries, access to diagnosis and treatment is limited by the lack of awareness among health providers, scarcity of specialists (1 neurologist per 1.2 million people) and medical costs (1). This educational initiative aimed to provide basic training in recognizing and treating PD and other forms of parkinsonism since dopaminergic treatment is available in Cameroon.

Methods: The NGO “Recover: Hospitals for Africa” organized a four-day training course in neurology in Yaoundé, Cameroon. Half a day was dedicated to movement disorders and taught by a neurologist with specific training (MK). All participants answered a questionnaire regarding education, work place and patient demographic data. Medical knowledge before and after the course was evaluated by 9 multiple choice questions. Frequencies and means were described and pre and post differences were analysed by the Wilcoxon Signed Rank Test.

Results: A total of 42 (22 women) health providers (7 doctors, 17 nurses, 18 other), with median age 35 years old (30-43), from rural and urban community medical centers from all parts of Cameroon participated. About 60% noted having seen PD patients in their clinic (1-2/year). At baseline, 33% participants identified the cardinal symptoms of parkinsonism and 38% recognized secondary causes (including pharmacological). Regarding PD, 52-59% had some basic epidemiological concepts, 42% considered PD more than a motor disease, 43% identified dopaminergic neuron degeneration as the primary cause and dopamine replacement as the essential treatment. Initially, the median number of correct answers was 5 (2-6) with 55% of participants passing, with no significant differences between health professions. After the 1.5 hour course, the number of correct answers increased to median 7 (5-8) (p=0.00) and 79% of participants passed (p=0.052).

Conclusions: Most of the participants had a poor understanding of diagnostic, etiological and therapeutic concepts of parkinsonism and PD that significantly improved after a 2 hour training course. The study identifies gaps in movement disorder training among a small sample of Cameroonian general health providers and suggests that teaching programs in parkinsonism are effective in improving basic knowledge.

References: 1. Dotchin C, Walker R. The management of Parkinson’s disease in sub-Saharan Africa. Expert Rev Neurother. 2012;12:661-6.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/training-in-parkinsonism-among-health-providers-in-cameroon/