Dados do Trabalho

Título

Neglected tropical diseases and their neurological manifestations: important differential diagnoses for Neurology

Resumo

Introduction: Neglected tropical diseases (NTDs) consist of a group of 20 infectious diseases caused by bacteria, helminths, protozoa, and viruses, affecting more than one billion people worldwide, mostly in the context of social disparities. Many of these pathologies cause systemic repercussions, including a wide variety of neurological manifestations.
Objective: To investigate the frequency and types of neurological involvement among NTDs in Brazil from January 2012 to December 2021 according to government databases.
Methodology: This is an epidemiological, descriptive, and retrospective study. Data were extracted from the SUS Hospital Information System (SIH/SUS). In addition, a review of the literature on the neurological manifestations of NTDs was performed.
Results: The study revealed 507,469 hospitalizations by NTDs in Brazil between 2012 and 2021, with the Northeast and Southeast regions being the most affected. The number of deaths in this period was 5,232, with higher burden among adults and those living in the Southeast region. The most relevant NTDs in the Brazilian context were Dengue, Leprosy, Visceral Leishmaniasis, Helminthiasis, and Trypanosomiasis. Neurological manifestations of varying degrees of severity and pattern of involvement have been described, including damage to the peripheral nervous system (plexopathy, Guillain-Barré syndrome, polyneuropathies, etc.) and central nervous system (encephalopathy, meningoencephalitis, stroke, epilepsy, etc.) The frequencies of the manifestations were not described in the SIH/SUS database. These findings are in accordance with our review of the literature, which emphasizes hanseniasis as an important cause of peripheral neuropathy in low and middle income countries, as well as neurocysticercosis as a significant cause of epilepsy in south-eastern countries like Brazil.
Conclusion: The neurological forms of NTDs contribute substantially to their morbidity and mortality, with heterogeneous manifestations being reported in the present survey. The frequencies of the findings found were not described, which points to the need for more research in the area and for improvements in the NTDs notification systems.