A prospective study of stroke sub-type from within an incident population in Tanzania
Design. This prospective community-based study identified cases as part of a stroke incidence study. Each patient underwent a full assessment including recording demographic information, taking a medical and drug history, and physical examination. A computed tomography (CT) head scan was used to classify strokes as resulting from a cerebral haemorrhage or ischaemia. The results were compared with the Siriraj and Allen scores, obtained from clinical findings.
Results. One hundred and thirty-two incident stroke cases were identified in the rural Hai demographic surveillance site (DSS) and 69 in the urban Dar-es-Salaam DSS; 63 patients with stroke due to ischaemia or cerebral haemorrhage from Hai and 17 from Dar-es-Salaam had a CT scan within 15 days of the stroke. Stroke was identified as due to ischaemia in 52 cases (82.5%) and to cerebral haemorrhage in 11 (17.5%) in Hai, and as due to ischaemia in 14 cases (82.4%) and to cerebral haemorrhage in 3 (17.6%) in Dar-es-Salaam. In both sites Siriraj and Allen scores were found to be of little value in predicting stroke sub-type.
Conclusions. The ratio of ischaemic to haemorrhagic stroke is much higher in our cohort than previously reported in sub-Saharan Africa, and is closer to that in high-income countries.
Richard W Walker, Northumbria Healthcare NHS Foundation Trust
Ahmed Jusabani, Kilimanjaro Christian Medical Centre, Moshi
Eric Aris, Department of Neurology, Muhimbili University Hospital, Dar-es-Salaam
William K Gray, Northumbria Healthcare NHS Foundation Trust
Dipayan Mitra, Department of Neuroradiology, Newcastle General Hospital, Newcastle-upon-Tyne
Mark Swai, Kilimanjaro Christian Medical Centre, Moshi
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Date published: 2011-05-06
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