Trends of frequency, mortality and risk factors among patients admitted with stroke from 2017 to 2019 to the medical ward at Kilimanjaro Christian Medical Centre hospital: a retrospective observational study

Moshi, B. et al. (2023) Trends of frequency, mortality and risk factors among patients admitted with stroke from 2017 to 2019 to the medical ward at Kilimanjaro Christian Medical Centre hospital: a retrospective observational study. BMJ Open, 13(7), e071918. (doi: 10.1136/bmjopen-2023-071918) (PMID:37524544) (PMCID:PMC10391824)

Abstract

Objective: The burden of stroke has increased in recent years worldwide, particularly in low-income and middle-income countries. In this study we aim to determine the number of stroke admissions, and associated comorbidities, at a referral hospital in Northern Tanzania. Design: This was a retrospective observational study. Setting: The study was conducted at a tertiary referral hospital, Kilimanjaro Christian Medical Centre (KCMC), in the orthern zone of Tanzania. Participants: The study included adults aged 18 years and above, who were admitted to the medical wards from 2017 to 2019. Outcome: The primary outcome was the proportion of patients who had a stroke admitted in the medical ward at KCMC and the secondary outcome was clinical outcome such as mortality. Methods: We conducted a retrospective audit of medical records from 2017 to 2019 for adult patients admitted to the medical ward at KCMC. Data extracted included demographic characteristics, previous history of stroke and outcome of the admission. Factors associated with stroke were investigated using logistic regression. Results: Among 7976 patients admitted between 2017 and 2019, 972 (12.2%) were patients who had a stroke. Trends show an increase in patients admitted with stroke over the 3 years with 222, 292 and 458 in 2017, 2018 and 2019, respectively. Of the patients who had a stroke, 568 (58.4%) had hypertension while 167 (17.2%) had diabetes mellitus. The proportion of admitted stroke patients aged 18–45 years, increased from 2017 (n=28, 3.4%) to 2019 (n=40, 4.3%). The in-hospital mortality related to stroke was 229 (23.6%) among 972 patients who had a stroke and female patients had 50% higher odds of death as compared with male patients (OR:1.5; CI 1.30 to 1.80). Conclusion: The burden of stroke on individuals and health services is increasing over time, which reflects a lack of awareness on the cause of stroke and effective preventive measures. Prioritising interventions directed towards the reduction of non-communicable diseases and associated complications, such as stroke, is urgently needed.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Kilonzo, Dr Kajiru and Halliday, Dr Jo and MMBAGA, Professor Blandina Theoph and Krauth, Dr Stefanie and Walker, Professor Richard and Siebert, Professor Stefan and McIntosh, Professor Emma and Yongolo, Dr Nateiya
• Authors: Moshi, B., Yongolo, N., Biswaro, S. M., Maro, H., Linus, S., Siebert, S., Nkenguye, W., McIntosh, E., Shirima, F., Njau, R. E., Andongolile, A. A., Mwanswila, M. J., Halliday, J. E.B., Krauth, S., Kilonzo, K., Walker, R. W., Temu, G. A., and Mmbaga, B. T.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment; College of Medical Veterinary and Life Sciences > School of Infection & Immunity
• Journal Name: BMJ Open
• Publisher: BMJ Publishing Group
• ISSN: 2044-6055
• ISSN (Online): 2044-6055
• Published Online: 31 July 2023
• Copyright Holders: Copyright © 2023 The Authors
• First Published: First published in BMJ Open 13(7):e071918
• Publisher Policy: Reproduced under a Creative Commons License

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
302121		NIHR Global Health Research Group on estimating the prevalence, quality and life, economic and societal impact of arthritis in Tanzania: a mixed methods study at University of Glasgow	Emma McIntosh	National Institute for Health Research (NIHR)	17/63/35	HW - Health Economics and Health Technology Assessment