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Chad is a landlocked country in central sub-Saharan Africa (figures 1–3). In 2015, the United Nations Development Program ranked Chad 185 out of 188 countries on the Human Development Index.1 Most of the approximately 14.5 million Chadians live in extreme poverty and deprivation; absolute poverty is expected to rise from 4.7 million people in 2012 to 6.3 million people in 2019.1 The life expectancy in Chad is just 51 years. Chad also suffers from so-called desertification from climate change, with large areas of dry land becoming increasingly arid, particularly in and around Lake Chad, which has shrunk 95% of its size in recent years with only modest recovery.1 2 In 2003, Chad became a petrol-producing country, and the current president is now in his fifth term of office.1 2 Long-term violence also affects Chad including intrastate conflicts. Four per cent of the population of Chad are refugees,1 many seeking asylum from recent wars in neighbouring countries, particularly in South Sudan and Central African Republic.
Almost nothing is officially reported on neurological disorders in Chad. Although Chad has eradicated poliomyelitis, it remains a high-risk region for reimportation of this virus from neighbouring regions prone to epidemic outbreaks.3 Many children remain at risk of a range of vaccine-preventable neurological diseases because of low vaccination …
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