Age specific prevalence of impairment and disability relating to hemiplegic stroke in the Hai District of northern Tanzania
Richard W Walkera, Donald G McLarty* b, Gabriel Masukic, Henry M Kitangec, David Whitingd, Adess F Moshid, John G Massawed, Richard Amarod, Ali Mhinad, K G M M Albertib, on behalf of the Adult Morbidity and Mortality Project
a Department of
Medicine, North Tyneside General Hospital, Rake Lane, North Shields,
Tyne and Wear, NE29 8NH, UK, b Department of Medicine, Medical School,
University of Newcastle upon Tyne, c Ministry
of Health, PO Box 9083, Dar-es-Salaam, Tanzania, d Adult Morbidity and
Mortality Project (AMMP), PO Box 65243, Dar-es-Salaam, Tanzania
Correspondence to: Dr R W Walker R.W.WALKER{at}ncl.ac.uk.
Received 21 May 1999 and in revised form 8 September 1999;
Accepted 29 October
1999
OBJECTIVES
To
determine the age specific prevalence of impairment and disability
relating to hemiplegic stroke in one rural area of Tanzania.
METHODSDuring the
yearly house to house census of the study population of 148 135 (85 152 aged 15 and over) in August 1994, specific questions were asked to
identify those who might be disabled from stroke. People thus
identified were subsequently interviewed and examined by one
investigator. In those in whom the clinical diagnosis of stroke was
confirmed a more detailed interview and examination relating to risk
factors and recovery was carried out.
RESULTSOne hundred
and eight patients, 61 men and 47 women, were identified with a median
age of 70 (range 18-100). Median age at first stroke was 65 years. The
age specific rates in this study were lower than previous studies in
developed countries. All were cared for at home although 23 (21%) were bedbound.
CONCLUSIONSAlthough
prevalence of impairment and disability related to stroke in this
population as a whole was low this is mainly explained by the age
structure, with less than 6% being aged 65 and over. Age standardised
rates for stroke with residual disability were about half those found
in previous studies in developed countries. Death from stroke in Africa
may be higher but data are limited. With the demographic transition
stroke is likely to become a more important cause of disability in
sub-Saharan Africa.
Keywords: stroke; disability; sub-Saharan Africa
* Deceased
© 2000 by Journal of Neurology, Neurosurgery, and Psychiatry
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