Methodological Challenges of Neuroepidemiological Studies in Low- and Middle-Income Countries
Résumé
Neuroepidemiological studies are challenging in low- and middle-income countries. This chapter focuses on methodological problems in studies conducted in these countries and attempts to give the reasons for their limitations. Regional conditions and environmental factors must be given careful consideration in the research design because of the importance of understanding the challenges of living in these environments. Existing information on neurological disorders is often not readily accessible; there is a lack of census data; and migratory patterns into cities make enumeration and sampling even more challenging. As there is usually no well-developed healthcare system, a door-to-door screening process is often the only way to identify those with neurological disorders. The questionnaires and study designs should be adapted from standardized protocols, pre-tested and validated in local conditions. The involvement of all health actors is mandatory to obtain strong evidence which could change practices in a durable way. Neuroepidemiological studies allow us to increase knowledge by applying validated approaches, and are used as decision tools as well as for the elaboration of advocacy/policy documents.