title: Quality of life after first-ever stroke: An interview-based study from Blantyre, Malawi.
abstract: BACKGROUND
  In post-stroke patients, impairment of quality of life (QOL) has been associated with functional impairment, age, anxiety, depression, and fatigue. Good social support, higher education, and better socioeconomic status are associated with better QOL among stroke survivors. In Africa, studies from Nigeria and Tanzania have reported on post-stroke QOL.
  
  
  OBJECTIVE
  The aim of this study was to describe QOL more than six months after first-ever stroke in Malawi.
  
  
  METHODS
  This was an interview-based study about a stroke-surviving cohort. Adult patients were interviewed six or twelve months after their first ever stroke. HIV status, modified stroke severity scale (mNIHSS) score, and brain scan results were recorded during the acute phase of stroke. At the time of the interviews, the modified Rankin scale (mRS) was used to assess functional outcome. The interviews applied the Newcastle Stroke-specific Quality of Life Measure (NEWSQOL). All the data were analysed using Statview™: the X(2) test compared proportions, Student's t-test compared means for normally distributed data, and the Kruskal-Wallis test was used for nonparametric data.
  
  
  RESULTS
  Eighty-one patients were followed up at least six months after the acute stroke. Twenty-five stroke patients (ten women) were interviewed with the NEWSQOL questionnaire. Good functional outcome (lower mRS score) was positively associated with better QOL in the domains of activities of daily living (ADL)/self-care (p = 0.0024) and communication (p = 0.031). Women scored worse in the fatigue (p = 0.0081) and cognition (p = 0.048) domains. Older age was associated with worse QOL in the ADL (p = 0.0122) domain. Seven patients were HIV-seroreactive. HIV infection did not affect post-stroke QOL.
  
  
  CONCLUSIONS
  In Malawi, within specific domains, QOL after stroke appeared to be related to patients' age, sex, and functional recovery in this small sample of patients.
authors.affiliation: Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland ; Department of Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.
authors.forename: T
authors.initials: T
authors.lastname: Heikinheimo
authors.affiliation: Department of Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.
authors.forename: D
authors.initials: D
authors.lastname: Chimbayo
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008295:Malawi; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012959:Socioeconomic Factors; D020521:Stroke / Q000523:psychology*; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D055815:Young Adult