Parkinsonism amongst white missionary workers in Malawi: 1889- 1989

Abstract

The study was launched in order to investigate a suspected increase of Parkinsonism among white Dutch Reformed Church (DRC) missionary workers in Malawi. Since the founding of a DRC mission in 1889 and up to 1989, 562 adults joined the Mission in Central Malawi. Eleven cases of Parkinsonism occurred in this population (incidence of 1,96%):3 women and 8 men. Only 2werc diagnosed while in Malawi, aged 55 and 59 years. In the rest, the diagnosis was made 8-50 (mean 21,4 years after departure from the country, at the mean age of 63,7 (43-80) years. The mean length of illness was 9 (4-18) years Four patients are still alive today, with a mean survival time of 15,2 (7-19) years. The mean length of stay in Malawi, for all patients, was 20,8 (4-45) years. The vast majority of international Parkinsonism surveys record prevalence, and could thus not be compared with our incidence figures. In view of this, and our relatively small sample, it was not possible to show an overall increase of Parkinsonism among DRC missionaries. However, when individual stations were compared, a statistically significant increase of cases were found on 3, situated within a common radius of 50 km. No reason for this phenomenon is evident, and we suggest that an epidemiological study of Parkinsonism among indigenous Malawians in the Central District may reveal interesting collaborative information.