The characteristics of stroke and its rehabilitation in Northern Tanzania

Abstract

Background Stroke causes great suffering and severe disability worldwide, and rehabilitation following a stroke seeks to restore lost functions. The extent to which stroke patients get access to rehabilitation in Tanzania is not well estimated, and drawing a current picture of the rehabilitation services for these persons is the first step in developing a more effective rehabilitation model in the country. Objective The objective of this study was to establish the characteristics of stroke and its rehabilitation at the Kilimanjaro Christian Medical Centre (KCMC), a consultant referral hospital in northern Tanzania. Methods This was a records-based descriptive study in which demographic, clinical, and rehabilitation information of stroke patients admitted to the KCMC between January 2012 and December 2015 was collected and audited. The means, percentages, and proportions were used to summarise the demographic, clinical, and rehabilitation patterns using SPSS version 24.0 software. The chi-squared statistic was used to examine the relationships between categorical variables, and a p -value<0.05 was considered statistically significant. Results Of the 17,975 patients admitted to the KCMC during the period of the study, 753 (4.2%) had suffered a stroke, with a mean age of 68.8 ± 16.4 years. The predominant cause of stroke was hypertension, which accounted for 546 (72.5%) patients. A total of 357 (47.4%) patients had various forms of rehabilitation during the admission to hospital. Following a discharge home 240 (31.9%) patients did not return to the hospital for the continuation of rehabilitation. Conclusion Stroke patients at the KCMC lack access to rehabilitation therapies. Insufficient access to rehabilitation therapies may warrant the need to explore alternative approaches such as tele-rehabilitation technologies in Tanzania.

Stroke Rehabilitation in Low- and Middle-Income Countries

“…Furthermore, occupational therapists and speech therapists are nearly absent across Zambia, and none are employed at our hospital so these services are unavailable to patients hospitalized at our facility. Similar findings have been reported from other hospitals in the region, including a study at Kilimanjaro Christian Medical Center Hospital, the largest and highest volume healthcare facility in Tanzania, where only 47% of adults hospitalized with stroke received access to rehabilitation during their hospitalization, and speech therapy was entirely unavailable 5 …”

“…Similar findings have been reported from other hospitals in the region, including a study at Kilimanjaro Christian Medical Center Hospital, the largest and highest volume healthcare facility in Tanzania, where only 47% of adults hospitalized with stroke received access to rehabilitation during their hospitalization, and speech therapy was entirely unavailable. 5 After discharge, the vast majority of Zambian patients return directly home into the care of a family member who serves as an informal caregiver. Postdischarge inpatient rehabilitation facilities are not available in the public sector, and in-home nursing and rehabilitation services do not exist.…”

Impact and quality of life on patients affected by cerebral vascular accident / Impacto e qualidade de vida no paciente acometido por Acidente Vascular Cerebral

“…There was a predominance of ischemic stroke in the patients, being the first episode, corroborating with a study among poststroke people, in which 63.6% had ischemic stroke and 80.5% had the first episode. 11 A study carried out in Sweden 12 with 72.5% of the patients who had stroke being carriers of systemic arterial hypertension. Similarly, the present study identified the same modifiable risk factor in predominance.…”