DESCRIPTION (provided by applicant): Very little is known about the prevalence of neurological disorders in people living in sub- Saharan Africa. There is an urgent need for accurate data in order for local officials to make informed evidence-based decisions on health care planning. There is also a critical need to develop a sustainable research infrastructure in these resource-poor settings to perform future analytical epidemiological, genetic and clinical studies. Our long-term goal is to help diverse African nations improve their ability to care for patients with neurological disease, by giving them the tools and infrastructure to assess the prevalence of their local neurological morbidity. Our objectives, in this and in our anticipated more comprehensive RO1 application are 1) to perform a population-based survey on the prevalence of neurological disorders in two African communities: the Hai District, Tanzania and Butajira, Ethiopia, and 2) to gain the skills necessary to assist diverse nations in assessing their neurological morbidity by studying two diverse African communities. We expect through this R21 grant to achieve three specific aims: 1) validate an updated instrument to assess for neurological disorders in resource-poor settings, 2) test the feasibility of our methods, and build the infrastructure to perform the population- based surveys, and 3) conduct pilot studies to collect preliminary data on other important scientific issues that can be addressed in the context of a prevalence study. We will do this by performing a pilot prevalence survey on neurological morbidity in the two communities, and performing several pilot studies to assess and refine our methods so as to be prepared to perform the full prevalence studies through an anticipated future R01 grant application. At the completion of the prevalence surveys, we will have identified the extent of all-cause neurological morbidity in two diverse African populations, created a physical and intellectual infrastructure for local African physicians and scientists to perform future population-based research, and gained the skills necessary to assist other African nations to do the same. PUBLIC HEALTH RELEVANCE: Without the foundation of accurate descriptive epidemiological data, African nations are not capable of properly planning for their health care needs. Without an existing research infrastructure, they are further prevented from performing population-based analytical epidemiology, genetic research and clinical studies. These surveys will serve as the crucial first step needed for African nations to plan properly for their health care and scientific research needs of the future.

PROJECT NARRATIVE Without the foundation of accurate descriptive epidemiological data, African nations are not capable of properly planning for their health care needs. Without an existing research infrastructure, they are further prevented from performing population-based analytical epidemiology, genetic research and clinical studies. These surveys will serve as the crucial first step needed for African nations to plan properly for their health care and scientific research needs of the future.