title: Early Mortality and Associated Factors among Patients with Stroke Admitted to a Large Teaching Hospital in Tanzania.
abstract: BACKGROUND
  Stroke is a major cause of death worldwide and 85.5% of stroke deaths occur in low- and middle-income countries due to stroke. The aim of this study was to investigate correlates and predictors of 30-day mortality in stroke patients in urban Tanzania.
  
  
  METHODS
  A prospective 30-day follow-up study was conducted at the Muhimbili National Hospital, Dar es Salaam, Tanzania. We recruited all patients with stroke seen at the Emergency Medicine Department and medical wards. Patients underwent medical history and physical examination including full neurological examination. For those who met the criteria for the diagnosis of stroke according to the World Health Organization, further data were collected, including cholesterol, creatinine, fasting blood glucose, full blood picture, human immunodeficiency virus serology, and electrocardiogram. Patients were followed up at 30 days from the date of stroke onset. The date and the cause of death of those participants who died within 30 days of stroke onset were recorded.
  
  
  RESULTS
  A total of 224 patients were recruited into the study, with follow-up data available on 186 (83.0%). At 30 days post stroke, 124 patients (66.7%) were still alive. Mortality was significantly higher among stroke patients who were over 65 years of age. Of the 62 who died, 54% died of aspiration pneumonia and 21% of septicemia. Patients with infection were 4.4 times more likely to die than thosewithout (P = .001).
  
  
  CONCLUSIONS
  Poststroke mortality rates were high. Many deaths were potentially preventable.
authors.affiliation: Internal Medicine Department, Muhimbili National Hospital, Dar es Salaam, Tanzania. Electronic address: okigocha@yahoo.com.
authors.forename: Kigocha
authors.initials: K
authors.lastname: Okeng'o
authors.affiliation: Internal Medicine Department, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
authors.forename: Pilly
authors.initials: P
authors.lastname: Chillo
authors.affiliation: Northumbria Healthcare NHS Foundation Trust, Department of Medicine, North Tyneside General Hospital, North Shields, United Kingdom.
authors.forename: William K
authors.initials: WK
authors.lastname: Gray
authors.affiliation: Northumbria Healthcare NHS Foundation Trust, Department of Medicine, North Tyneside General Hospital, North Shields, United Kingdom; Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: Richard W
authors.initials: RW
authors.lastname: Walker
authors.affiliation: Internal Medicine Department, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
authors.forename: William
authors.initials: W
authors.lastname: Matuja
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D012189:Retrospective Studies; D020521:Stroke / Q000453:epidemiology* / Q000401:mortality*; D013636:Tanzania / Q000453:epidemiology
keywords: Tanzania; aspiration pneumonia; case fatality; mortality; stroke; sub-Saharan Africa