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An Epidemiological Study of Stroke Hospitalizations in Maputo, Mozambique

2010; Lippincott Williams & Wilkins; Volume: 41; Issue: 11 Linguagem: Inglês

10.1161/strokeaha.110.594275

1524-4628

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,

Global Public Health Policies and Epidemiology

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.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.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.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.