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Correlates of short- and long-term case fatality within an incident stroke population in Tanzania

R W Walker, A Jusabani, E Aris, W K Gray, F Mugusi, M Swai, K G Alberti, N Unwin

Abstract


Background. This study aimed to identify correlates of case fatality within an incident stroke population in rural Tanzania.

Methods. Stroke patients, identified by the Tanzanian Stroke Incidence Project, underwent a full examination and assessment around the time of incident stroke. Records were made of demographic data, blood pressure, pulse rate and rhythm, physical function (Barthel index), neurological status (communication, swallowing, vision, muscle activity, sensation), echocardiogram, chest X-ray and computed tomography (CT) head scan. Cases were followed up over the next 3 - 6 years.

Results. In 130 incident cases included in this study, speech, language and swallowing problems, reduced muscle power, and reduced physical function were all significantly correlated with case fatality at 28 days and 3 years. Age was significantly correlated with case fatality at 3 years, but not at 28 days post-stroke. Smoking history was the only significant correlate of case fatality at 28 days that pre-dated the incident stroke. All other significant correlates were measures of neurological recovery from stroke.

Conclusions. This is the first published study of the correlates of post-stroke case fatality in sub-Saharan Africa (SSA) from an incident stroke population. Case fatality was correlated with the various motor impairments resulting from the incident stroke. Improving poststroke care may help to reduce stroke case fatality in SSA.

Authors' affiliations

R W Walker, North Tyneside General Hospital, Tyne and Wear, and Institute of Health and Society, University of Newcastle-upon-Tyne

A Jusabani, Kilimanjaro Christian Medical Centre, Moshi

E Aris, Department of Neurology, Muhimbili University Hospital, Dar-es-Salaam

W K Gray, North Tyneside General Hospital, Tyne and Wear, UK

F Mugusi, Department of Neurology, Muhimbili University Hospital, Dar-es-Salaam

M Swai, Kilimanjaro Christian Medical Centre, Moshi

K G Alberti, Department of Endocrinology and Metabolism, St Mary’s Hospital Campus, Imperial College, London

N Unwin, Institute of Health and Society, University of Newcastle-upon-Tyne, UK, and Faculty of Medical Sciences, Cave Hill Campus, University of the West Indies, Barbados

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Keywords

Stroke; Tanzania; Mortality; Correlates; Case-fatality; sub-Saharan Africa

Cite this article

South African Medical Journal 2013;103(2):107-112. DOI:10.7196/SAMJ.5793

Article History

Date submitted: 2012-03-01
Date published: 2012-12-11

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