NIMHANS

DEPARTMENTS

Department of

Epidemiology

NEUROEPIDEMIOLOGY

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Neurological problems are major unrecognized public health problems. With paucity of trained manpower, the emphasis till date has been on delivery of services, more so in urban areas. The distribution and determinants of neurological disorders is very vital for planning delivery of services and to develop preventive programmes. Neurological disorders being chronic progressive disorders place significant burden on families and societies. The departmental activities in collaboration with department of neurology at NIMHANS have been in stroke, epilepsy, movement disorders and Neuro-disabilities, focusing on research, manpower development and service delivery activities.

Estimating the Burden of Neurological disorders

Overcoming the methodological limitations of earlier epidemiological studies, The Bangalore urban rural neuroepidemiological (BURN) study undertaken by the departments of Epidemiology and Neurology examined the burden and pattern of neurological disorders. Being the first largest population based survey in India undertaken with standardized research methods, the findings revealed that nearly 30 million people are in need of neurological services in the country.

Cerebrovascular accidents (Stroke)

Stroke is a leading cause of mortality, morbidity, disability and socioeconomic losses in India. During the past few years, the activities include – (1) analysis of records for delineating mortality patterns, (2) burden of stroke, risk factors, disabilities and outcome ( BURN study) , (3) Establishing hospital based stroke registry ( NIMHANS study) , (4) population based stroke registry ( WHO STEPS stroke project), and (5) risk factor studies .

In 2004, with support and guidance from World Health Organization (Geneva and New Delhi) the department in collaboration with the department of neurology completed the first feasibility study of establishing population based stroke registry in Bangalore using the WHO recommended STEPS- Stroke approach. The study will be expanded to the larger population of Bangalore in the year 2007.

EPILEPSY

Epilepsy is the most common neurological disorder across the World. Epilepsy can be easily diagnosed and effectively managed at even peripheral levels with simple medicines. The studies in the department have focused on examining various dimensions ( prevalence, pattern, risk factors and impact) of epilepsy through hospital based and population based studies. Hot Water epilepsy, one of the regional variations of epilepsy has been examined in detail. Capacity strengthening programmes for State level administrators, general practitioners, physicians and nodal neurologists has been completed. Efforts are in focus to develop a National Epilepsy Control Programme in India.

Movement Disorders

With increasing elderly population in India, neurological problems among the elderly, especially Parkinson's disease is increasing rapidly. Epidemiological, sociological and genetic aspects of Parkinson's disease have been examined through community based and hospital based studies. The development of screening and diagnostic instruments that can be used in large population based research studies has been a significant development. Research activities in collaboration with department of Neurology have been completed in hospital settings, elderly homes and in community settings.

Neurodisabilities

Neurological disorders due to their chronic progressive nature of illness result in significant amount of disabilities affecting the over all quality of life of the affected individual and their families. The problem, pattern, impact and disabilities has been studied through hospital and population based studies in collaboration with the department of neurology at NIMHANS. The findings of these studies have been used for training programmes and also to develop neuro rehabilitation as the thrust area at NIMHANS.

Health Systems Research

To strengthen service delivery, several health systems research initiatives have been taken up. Two major efforts have been a) Factors affecting utilization of services by epilepsy patients in rural areas - A descriptive study and b) Use of Complementary and Alternate systems of Medicine in patients with neurological disorders seeking care at NIMHANS.

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