Early insights from a multi-centre national stroke surveillance initiative in Tanzania

IF 2.1 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2026-03-01 Epub Date: 2026-01-21 DOI:10.1016/j.jstrokecerebrovasdis.2026.108571

Sarah Shali Matuja , Azan Nyundo , Emmanuel Assey , Joel Bwelemo , Marieke Dekker , Sarah Urasa , Emanuel Makarius , Peter Kishimbo , Yudathadei Baltazar , Baraka Alphonce , Joshua Ngimbwa , Philip Adebayo , Sipora Siha , Anney Chagula , Mary Libena , Theresia Lutufyo , Mohamed A Mnacho , Faraja S Chiwanga , Kigocha Okeng’o , Brighton Mushengezi , William Matuja

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引用次数: 0

Abstract

Background

Stroke is a leading cause of death and disability globally, with sub-Saharan Africa, bearing the greatest burden. Tanzania has only one active stroke registry, limiting evidence-based care and policy development. We aimed to expand the registry into a multi-centre study across eight major tertiary hospitals to generate baseline data for a national stroke registry.

Methods

From January to August 2024, we analysed de-identified data from adults (≥18 years) admitted with a World Health Organisation defined stroke. Data collected included demographics, risk factors, imaging, and in-hospital mortality. Logistic regression identified predictors of mortality.

Results

A total of 1000 patients were registered with a mean age 60.2±15 years and 56.2% (562/1000) were females. Most strokes occurred in those aged 50-69 years 46.3% (463/1000). Hypertension was the most common risk factor 90.1% (901/1000), followed by diabetes 13.1% (131/1000), prior stroke 10.6% (106/1000) and HIV infection 3.5% (35/1000). Haemorrhagic and ischaemic strokes accounted for 57.9% (579/1000) and 38.3% (383/1000) of cases, respectively; and 5% (19/383) of ischaemic strokes presented within 4.5 h from symptom onset. In-hospital mortality was 31.5% (315/1000), highest among patients aged 50–59 years (23.2%). Independent predictors of mortality included previous cardiac disease (aOR 2.15; 95% CI: 1.18–3.94) and haemorrhagic stroke (aOR 1.38; 95% CI: 1.12–2.02).

Conclusions

Stroke imposes a high burden in Tanzania, with substantial mortality and delayed presentation. Strengthening hypertension control, early stroke recognition, and organized stroke unit care are critical priorities. These findings provide foundational data for the national stroke surveillance initiative and support evidence-based planning for stroke prevention, acute care, and system readiness across Tanzania.

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坦桑尼亚多中心国家卒中监测倡议的早期见解。

背景：中风是全球死亡和残疾的主要原因，其中撒哈拉以南非洲负担最重。坦桑尼亚只有一个有效的中风登记，限制了循证护理和政策制定。我们的目标是将登记扩展为跨八家主要三级医院的多中心研究，为国家卒中登记生成基线数据。方法：从2024年1月至8月，我们分析了来自世界卫生组织定义的卒中入院的成年人（≥18岁）的去识别数据。收集的数据包括人口统计学、危险因素、影像学和住院死亡率。逻辑回归确定了死亡率的预测因素。结果：共登记患者1000例，平均年龄60.2±15岁，56.2%（562/1000）为女性。以50 ~ 69岁者居多，占46.3%（463/1000）。高血压是最常见的危险因素，占90.1%(901/1000)，其次是糖尿病13.1%(131/1000)，既往中风10.6% (106/1000)，HIV感染3.5%（35/1000）。出血性卒中和缺血性卒中分别占57.9%（579/1000）和38.3% (383/1000)；5%（19/383）的缺血性卒中患者在症状出现后4.5年内出现。住院死亡率为31.5%(315/1000)，在50-59岁的患者中最高（23.2%）。死亡率的独立预测因子包括既往心脏病（aOR 2.15; 95% CI: 1.18-3.94）和出血性中风（aOR 1.38; 95% CI: 1.12-2.02）。结论：中风在坦桑尼亚造成了很高的负担，死亡率高且延迟出现。加强高血压控制、早期卒中识别和有组织的卒中单位护理是当务之急。这些发现为国家卒中监测倡议提供了基础数据，并支持坦桑尼亚卒中预防、急性护理和系统准备的循证规划。

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.