Title

Post-stroke case fatality within an incident population in rural Tanzania

Document Type

Article

Department

Imaging and Diagnostic Radiology (East Africa)

Abstract

Background and purpose

To establish post-stroke case fatality rates within a community based incident stroke population in rural Tanzania.

Methods

Incident stroke cases were identified by the Tanzanian Stroke Incidence Project and followed-up over the next 3–6 years. In order to provide a more complete picture, verbal autopsy (VA) was also used to identify all stroke deaths occurring within the same community and time period, and a date of stroke was identified by interview with a relative or friend.

Results

Over 3 years, the Tanzanian Stroke Incidence Project identified 130 cases of incident stroke, of which 31 (23.8%, 95% CI 16.5 to 31.2) died within 28 days and 78 (60.0%, 95% CI 51.6 to 68.4) within 3 years of incident stroke. Over the same time period, an additional 223 deaths from stroke were identified by VA; 64 (28.7%, 95% CI 20.9 to 36.5) had died within 28 days of stroke and 188 (84.3%, 95% CI 78.1 to 90.6) within 3 years.

Conclusions

This is the first published study of post-stroke mortality in sub-Saharan Africa from an incident stroke population. The 28 day case fatality rate is at the lower end of rates reported for other low and middle income countries, even when including those identified by VA, although CIs were wide. Three year case fatality rates are notably higher than seen in most developed world studies. Improving post-stroke care may help to reduce stroke case fatality in sub-Saharan Africa.

Comments

This work was published before the author joined Aga Khan University.

Publication

Neurology,Neurosurgery & Psychiatry

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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