An epidemiological study of stroke hospitalizations in maputo, mozambique: A high burden of disease in a resource-poor country

Albertino Damasceno, Joana Gomes, Ana Azevedo, Carla Carrilho, Vitória Lobo, Hélder Lopes, Tavares Madede, Pius Pravinrai, Carla Silva-Matos, Sulemane Jalla, Simon Stewart, Nuno Lunet

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Abstract

Background and Purpose: Already a major cause of death and disability in high-income countries, the burden of stroke in sub-Saharan Africa is also expected to be high. However, specific stroke data are scarce from resource-poor countries. We studied the incidence, characteristics, and short-term consequences of hospitalizations for stroke in Maputo, Mozambique. Methods: Over 12 months, comprehensive data from all local patients admitted to any hospital in Maputo with a new stroke event were prospectively captured according to the World Health Organization's STEPwise approach to stroke surveillance program. Disability levels (pre-and posthospital discharge) and short-term case-fatality (in-hospital and 28 days) were also studied. Results: Overall, 651 new stroke events (mean age 59.1±13.2 years and 53% men) were captured by the registry with 601 confirmed by CT scan (83.4%) or necropsy (8.9%). Crude and adjusted (world reference population) annual incidence rates of stroke were 148.7 per 100 000 and 260.1 per 100 000 aged 25 years, respectively. Of these, 531 (81.6%) represented a first-ever stroke event comprising 254 ischemic (42.0%) and 217 (36.1%) an intracerebral hemorrhage. Before admission, 561 patients (86.2%) had hypertension and 271 (41.6%) had symptoms for >24 hours. In-hospital and 28-day case-fatality were 33.3% and 49.6% (72.3% for hemorrhagic stroke), respectively. From almost no preadmission disability, 64.4% of 370 survivors at 28 days had moderate-to-severe disability. Conclusions: The burden of disease associated with stroke is high in Maputo, emphasizing the importance of primary prevention and improvement of the standards of care in a developing country under epidemiological transition.

Original languageEnglish
Pages (from-to)2463-2469
Number of pages7
JournalStroke
Volume41
Issue number11
DOIs
Publication statusPublished - 1 Nov 2010
Externally publishedYes

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Keywords

  • mozambique
  • population surveillance
  • stroke

Cite this

Damasceno, A., Gomes, J., Azevedo, A., Carrilho, C., Lobo, V., Lopes, H., Madede, T., Pravinrai, P., Silva-Matos, C., Jalla, S., Stewart, S., & Lunet, N. (2010). An epidemiological study of stroke hospitalizations in maputo, mozambique: A high burden of disease in a resource-poor country. Stroke, 41(11), 2463-2469. https://doi.org/10.1161/STROKEAHA.110.594275