Stroke Burden in Rwanda: A Multicenter Study of Stroke Management and Outcome

Nkusi, Agabe Emmy; Muneza, Sévérien; Nshuti, Steven; Hakizimana, David; Munyemana, Paulin; Nkeshimana, Menelas; Rudakemwa, Emmanuel; Amendezo, Etienne

doi:10.1016/j.wneu.2017.06.163

Cited by 28 publications

(37 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is in accordance with other hospital based study done at University of Gondar Teaching Hospital (8) and population based cross sectional study in China (18). In contrast to this, a study done in Rwanda showed that initial presentation with severe stroke was the major cause of death among stroke patients (20).…”

Section: Discussionsupporting

confidence: 89%

“…This is in line with various studies conducted at different part of world; 55.6% (8), 56.7% (9), 65.8% (10), 69.4% (14), 85.7% (12) and 91.7% (18). Contrastingly, hemorrhagic stroke was the most common in studies conducted at St. Paul's Teaching Hospital (61.3%) (13), Jimma (64.3%) (19) and Rwanda (65%) (20). This disparity might be due to the difference in the prevalence of risk factors and co-morbidities especially cardiovascular risk factors in St. Paul's Teaching Hospital, Jimma and Rwanda.…”

Section: Discussionmentioning

confidence: 99%

“…This is in line with other findings reported by Temesgen et al, Chang et al and Kassaw (10,12,21). Contrastingly, Rwandan study by Nkusi et al revealed that loss of consciousness was found to be significantly associated with poor treatment outcome (20). Disparity of this finding might be attributed to the high prevalence of hemorrhagic stroke than ischemic stroke among study participants by 1.85:1 in Rwanda (20).…”

Section: And In Sri Lanka Bymentioning

confidence: 91%

“…Eighty-five (76.6%) of stroke patients complained hemi-paresis ( Table 2). Majority of the study participants (89, 80.2%) suffered from ischemic stroke while 18% (20) were suffered from hemorrhagic type of stroke ( Figure 1).…”

Section: Clinical Characteristics and Co-morbid Conditions Of Hospitamentioning

confidence: 99%

See 3 more Smart Citations

Management practice, and treatment outcome and its associated factors among hospitalized stroke patient at Ambo University Referral Hospital, Ethiopia: an Institutional Based Cross Sectional Study

Gelaw

Betero

Temesgen

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: Although stroke has been consistently reported as one of the three leading causes of morbidity and mortality in the past few years in Ethiopia, there is a paucity of data regarding to stroke treatment outcomes and associated factors. Hence, this study was aimed to assess management practice, and treatment outcome and its associated factors among hospitalized stroke patients.Method an institutional based cross sectional study was conducted among 111 hospitalized stroke patients in the medical ward of Ambo University Referral Hospital(AURH), who had been hospitalized for the last three years (March 30/2016- May30/2019). All patients diagnosed with stroke and hospitalized in the medical ward of AURH were included in the study. Data were analyzed with SPSS version 25.0 statistical software. Bivariate and multivariate binary logistic regression analysis was conducted to identify the predictors of poor treatment outcome.Result The present study showed that ischemic stroke was the most prevalent (80.1%) form of stroke diagnosed in the study setting. Nonetheless, 18.2% of patients were diagnosed with hemorrhagic stroke. Among 111 study participants, 69 (62.2%) patients had good treatment outcome. From 42(37.8%) study participants with poor treatment outcome, 18(42.8%) were dead and 12 (28.6%) were with disability and left against medical advice on self and family request while the remaining 12 (28.6%) were referred to other higher health facility. Social history (substance abuse P=00.046, AOR=2.684, 95%CI 1.091-6.604), age (P=0.026, AOR= 3.256, 95%CI = 1.145-9.260) and chief compliant (P=0.009, AOR=0.254, 95%CI=0.091-0.708) were the predictors of treatment outcome among hospitalized stroke patients. Other variables like types of stroke, co-morbidity, and others did not show significant association with treatment outcome.Conclusion The present study showed that ischemic stroke was the most predominantly diagnosed type of stroke in our setting. Acetyl salicylic acid and ACE inhibitor based regimens were frequently used in the management of stroke and hypertension, respectively. Nearly one third of the study participants had good treatment outcome. Nonetheless, death was reported in 16.2% of hospitalized stroke patients in the study setting. Being older and substance abusers, and the presence of hemiparesis during the initial hospital admission were significant predictors of poor treatment outcome.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: And In Sri Lanka Bymentioning

confidence: 91%

Section: Clinical Characteristics and Co-morbid Conditions Of Hospitamentioning

confidence: 99%

See 2 more Smart Citations

Management practice, and treatment outcome and its associated factors among hospitalized stroke patient at Ambo University Referral Hospital, Ethiopia: an Institutional Based Cross Sectional Study

Gelaw

Betero

Temesgen

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…Globally, the prevalence of hypertension is approximately 40% for adults aged 25 years and over, with the highest rates in Africa (~ 46%) and lowest in high‐income countries (~ 35%) . Although the prevalence of hypertension in Rwanda (a low‐income country in Africa) is not well known, a recent Rwandan study conducted on stroke management and outcome suggested that approximately 54% of patients diagnosed with stroke were hypertension treatment naïve, whereas 22% were unaware of having the disease …”

Section: Introductionmentioning

confidence: 99%

Blood pressure measurement techniques: Assessing performance in outpatient settings of a tertiary‐level hospital in Rwanda

Kabakambira

Niyonsenga

Hategeka³

et al. 2018

J of Clinical Hypertension

View full text Add to dashboard Cite

Cardiovascular diseases (CVD) are the leading cause of mortality globally. Hypertension is a known modifiable risk factor for CVD. Diagnosis and management of hypertension hinges upon accurate blood pressure (BP) measurement. In this study, we assessed performance to recommended guidelines for BP measurement in Rwanda. In 2017, a cross-sectional study investigating performance on 11 techniques recommended for BP measurement was undertaken across outpatient settings of 3 departments at the University Teaching Hospital of Kigali, Rwanda. Performance was checked by an inside observer. The study enrolled 164 patients. The overall mean performance on the 11 BP measurement techniques was 5.69 (±1.02) out of the 11 possible points. There was no significant difference in performance across departments (P = .28). The findings suggest that performance on currently recommended guidelines for BP measurement is not optimal. Going forward, it is important to implement interventions that will enhance performance given that diagnosis and management of hypertension depend upon accurate BP measurement.

show abstract

Identifying, Prioritizing and Visually Mapping Barriers to Injury Care in Rwanda: A Multi‐disciplinary Stakeholder Exercise

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background Whilst injuries are a major cause of disability and death worldwide, a large proportion of people in low- and middle-income countries lack timely access to injury care. Barriers to accessing care from the point of injury to return to function have not been delineated. Methods A two-day workshop was held in Kigali, Rwanda in May 2019 with representation from health providers, academia, and government. A four delays model (delays to seeking, reaching, receiving, and remaining in care) was applied to injury care. Participants identified barriers at each delay and graded, through consensus, their relative importance. Following an iterative voting process, the four highest priority barriers were identified. Based on workshop findings and a scoping review, a map was created to visually represent injury care access as a complex health-system problem. Results Initially, 42 barriers were identified by the 34 participants. 19 barriers across all four delays were assigned high priority; highest-priority barriers were “ Training and retention of specialist staff ”, “ Health education/awareness of injury severity ”, “ Geographical coverage of referral trauma centres ”, and “ Lack of protocol for bypass to referral centres ”. The literature review identified evidence relating to 14 of 19 high-priority barriers. Most barriers were mapped to more than one of the four delays, visually represented in a complex health-system map. Conclusion Overcoming barriers to ensure access to quality injury care requires a multifaceted approach which considers the whole patient journey from injury to rehabilitation. Our results can guide researchers and policymakers planning future interventions.

show abstract

Stroke Burden in Rwanda: A Multicenter Study of Stroke Management and Outcome

Cited by 28 publications

References 14 publications

Management practice, and treatment outcome and its associated factors among hospitalized stroke patient at Ambo University Referral Hospital, Ethiopia: an Institutional Based Cross Sectional Study

Management practice, and treatment outcome and its associated factors among hospitalized stroke patient at Ambo University Referral Hospital, Ethiopia: an Institutional Based Cross Sectional Study

Blood pressure measurement techniques: Assessing performance in outpatient settings of a tertiary‐level hospital in Rwanda

Identifying, Prioritizing and Visually Mapping Barriers to Injury Care in Rwanda: A Multi‐disciplinary Stakeholder Exercise

Contact Info

Product

Resources

About