Stroke Mortality Outcomes in Uganda

Olum, Sam; Muyingo, Anthony; Wilson, Tony; Demaerschalk, Bart M.; Hoxworth, Joseph M.; Zhang, Nan; Hentz, Joseph G.; Almasi‐Hashiani, Amir; Kayanja, Adrian; Aguilar, Maria I.; O’Carroll, Cumara B

doi:10.1016/j.jstrokecerebrovasdis.2021.105661

Cited by 9 publications

(7 citation statements)

References 29 publications

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“…26 The majority of our patients came within weeks from the onset of the clinical features to the time of brain CT imaging. This is in contrast to the findings of a study done in Mbarara regional referral hospital by Olum et al 27 in which the average time from symptom onset to presentation at the hospital was 3 days, with no significant difference between male and female patients. This could be due to the fact that most patients tend to seek health care as their condition or weakness worsens.…”

Section: Discussioncontrasting

confidence: 99%

“…Ischemic stroke was the predominant type followed by hemorrhagic stroke and subarachnoid hemorrhage. These findings conform with both local and global trends of stroke types reported by previous studies 27,32 . The high incidence of ischemic stroke is probably due to the multiple risk factors associated with ischemic stroke, as opposed to hemorrhagic stroke where hypertension is the sole most significant risk factor.…”

Section: Discussionsupporting

confidence: 91%

“…These findings conform with both local and global trends of stroke types reported by previous studies. 27 , 32 The high incidence of ischemic stroke is probably due to the multiple risk factors associated with ischemic stroke, as opposed to hemorrhagic stroke where hypertension is the sole most significant risk factor. However, higher incidences of hemorrhagic stroke have been reported in some African countries.…”

Section: Discussionmentioning

confidence: 99%

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Correlation between clinical and brain computed tomography findings of stroke patients: A cross‐sectional study

Mboizi

Sereke

Nassanga

et al. 2023

Health Science Reports

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Background and Aims: In developing countries, the burden of stroke is growing and causing significant morbidity and disability with high mortality rates. Neuroimaging plays a crucial role in differentiating ischemic stroke from an intracerebral hemorrhage, as well as entities other than stroke. This study sought to determine the correlation between the clinical and brain CT scan findings of stroke patients attending three hospitals in Kampala, Uganda.Methods: This was a cross-sectional study of clinically suspected stroke patients who were sent for brain CT scan at three selected hospitals in Kampala, Uganda. All brain CT scans of patients with suspected stroke were evaluated and the Alberta stroke program early CT score (ASPECTS) was used for middle cerebral artery (MCA) strokes. Univariate analysis was used to describe the clinico-demographic and brain CT features of stroke and summarized them as percentages. Bivariate and multivariate analysis were used to determine the adjusted odds ratios as a measure of association with a 95% confidence interval (CI).Results: Of the 270 study participants, 141 (52.2%) were male. 162 (60%) had CT findings of stroke, and 90 (33.3%) had normal brain CT findings. Eighteen (6.7%) had other CT findings like tumor, dural hemorrhage, epidermoid cyst, and others.Ischemic stroke, hemorrhagic stroke, and subarachnoid hemorrhage accounted for 124 (45.9%), 34 (12.6%), and 4 (1.5%) respectively. Limb weakness (55.2%), headache (41.1%), and loss of consciousness (39.3%) were associated with stroke findings on CT. Among the acute ischemic strokes, 30 (73.2%) had a worse (0-7) ASPECT score. Those aged ≥65 years were associated with a worse ASPECTS [AOR: 22.01, (95% CI: 1.58-306.09) p = 0.021]. Conclusion: More than a third of patients with a clinical diagnosis of stroke had either no CT features of stroke or had other findings. The most commonly affected vascular territory was left MCA. Old age was strongly associated with having the worst ASPECTS score.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Correlation between clinical and brain computed tomography findings of stroke patients: A cross‐sectional study

Mboizi

Sereke

Nassanga

et al. 2023

Health Science Reports

View full text Add to dashboard Cite

show abstract

“…Ischemic stroke was the predominant type followed by hemorrhagic stroke and subarachnoid hemorrhage. These ndings conform with both local and global trends of stroke types reported by previous studies (27,32). The high incidence of ischemic stroke is probably due to the multiple risk factors associated with ischemic stroke, as opposed to hemorrhagic stroke where hypertension is the sole most signi cant risk factor.…”

Section: Discussionsupporting

confidence: 93%

“…The majority of our patients came within weeks from the onset of the clinical features to the time of brain CT imaging. This is in contrast to the ndings of a study done in Mbarara regional referral hospital by Olum et al,2021 in which the average time from symptom onset to presentation at the hospital was 3 days, with no signi cant difference between male and female patients (27).-leave it out, when most pts get weakness they tend to seek health care. This study attributes the late presentation for neuroimaging to time lost during the referral of patients since the study was conducted in hospitals at the tertiary level.…”

Section: Discussioncontrasting

confidence: 79%

Correlation of neurological clinical and brain computed tomography findings of stroke patients – a multicenter study from a low-income setting

Mboizi

Sereke

Nassanga

et al. 2022

Preprint

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Background: In developing countries like Uganda, the burden of stroke is growing and causing significant morbidity and disability with high mortality rates. Neuroimaging is required to differentiate ischemic stroke from an intracerebral hemorrhage, as well as to diagnose entities other than stroke. Therefore, understanding the clinico-demographic features and brain Computed Tomography (CT) findings of stroke as well as their correlation is of utmost value in stroke management. Hence, this study sought to determine the clinical and brain CT scan findings of stroke patients attending selected centers in Kampala. Mention ASPECTS briefly Methods: This was a cross-sectional study of clinically suspected stroke patients at three selected hospitals in Kampala, Uganda. All brain CT scans of patients with suspected stroke were evaluated and The Alberta stroke programme early CT score (ASPECTS) a 10-point quantitative topographic CT scan score used for middle cerebral artery (MCA) stroke patients. Data on the clinical-demographic and cranial CT findings were collected, and entered into REDCap software. Univariate analysis was used to describe the clinico-demographic and cranial CT features of stroke and summarized them as percentages. Further analysis was done at bivariate and multivariate levels to determine the adjusted odds ratios as a measure of association with a 95% confidence interval. Results: Of the 270 study participants,141(52.2%) were male. 162(60%) had CT findings of stroke, and 90(33.3%) had normal cranial CT findings. While 18(6.7%) had other CT findings like a tumor, dural hemorrhage, epidermoid cyst, and others. The ischemic stroke, hemorrhagic stroke, and subarachnoid hemorrhage accounted for 124(45.9%), 34(12.6%), and 4(1.5%) respectively. Limb weakness (55.2%), headache (41.1%), and loss of consciousness (39.3%) were associated with stroke findings on CT. Among the acute ischemic strokes, 30(73.2%) had a worse (0-7) ASPECT score. Those aged ≥65 years were associated with a worse ASPECTS [AOR: 22.01, (95%CI:1.58-306.09) p-value =0.021]. Conclusion: Currently, non-contrasted brain CT is the first line imaging modality for diagnosis, differentiation of the stroke types, patient management, treatment, and timely referral to a stroke center. The clinical diagnosis of stroke is inadequate to exclude other stroke mimics. Hypertension and advanced age are the most prevailing risk factors attributed to both ischemic and hemorrhagic stroke and patients over 65 years were associated with a worse ASPECT score.

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Risk Factors for Stroke in HIV-Positive and-Negative Patients in Pretoria, South Africa

Kroon

Zyl

Schutte

et al. 2021

Journal of Stroke and Cerebrovascular Diseases

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Stroke Mortality Outcomes in Uganda

Cited by 9 publications

References 29 publications

Correlation between clinical and brain computed tomography findings of stroke patients: A cross‐sectional study

Correlation between clinical and brain computed tomography findings of stroke patients: A cross‐sectional study

Correlation of neurological clinical and brain computed tomography findings of stroke patients – a multicenter study from a low-income setting

Risk Factors for Stroke in HIV-Positive and-Negative Patients in Pretoria, South Africa

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