Abstract:

Background: Stroke is still a major problem worldwide. In developing countries, Tanzania being one of them, efforts to prevent, control and manage of stroke are animal as compared to infectious diseases such as HIV/AIDS, Malaria and TB. No enough fund served for screening people with risk factors, diagnosis and management of stroke. Therefore, it was necessary to conduct this study in two sites, one in developed countries and the other in developing countries to compare the risk factors, type and mortality of stroke aimed at raising the concern of the governing agency and NGOS on the burden of stroke in the developing countries, Tanzania being one of the most affected countries.

Methods: This study was a retrospective cross-sectional study. Documented patients’ information was obtained from medical record department and data filled in a structured questionnaire. Data was then analysed using SPSS version 17 and results presented in tables.

Results: A total of 50 patients at Julius – Maximillian University Hospital of Wurzburg and a total of 36 patients at Bugando medical centre from January 2011 to October 2011 were enrolled for the study. At Bugando medical centre most of stroke patients were aged between 36-55 (50%) who were either peasants (33%) or employed (28%) while Julius – Maximillian University Hospital of Wurzburg most of patient were aged more than 65 (68%) and retired (80%). At both sites, males were more infected than females although men a slightly more affected in Julius – Maximillian University Hospital of Wurzburg (62%) compared to Bugando medical centre (58%) and females more affected at Bugando medical centre (42%) as compared to Julius – Maximillian University Hospital of Wurzburg (38%). In Julius – Maximillian University Hospital of Wurzburg, there was a greater percent of stroke patients (36%) with history of smoking than Bugando medical centre (22%) meanwhile the percent of alcohol was not more higher at Bugando medical centre (50%) than Julius – Maximillian University Hospital of Wurzburg (46%). There were more stroke patients with history of high level of Cholesterol at Julius – Maximillian University Hospital of Wurzburg (14%) as compared to Bugando medical centre (2.8%) as well as more stroke patients with diabetes mellitus at Julius – Maximillian University Hospital of Wurzburg (40%) as compared to Bugando medical centre (13.9%). There were not a big difference of stroke patients with hypertension at Bugando medical centre (86%) as compared with Julius – Maximillian University Hospital of Wurzburg (82%), but there was a closer familial risk factor to cardiovascular disease at Bugando medical centre (31%) compared to Julius – Maximillian University Hospital of Wurzburg (20%) in patients with stroke. At both sites, most of stroke patients had history of obesity (BMI>30) although there were more obese in Julius – Maximillian University Hospital of Wurzburg (36%) as compared to Bugando medical centre (28%). In Julius – Maximillian University Hospital of Wurzburg all stroke patients underwent a CT scan which revealed all patients to have ischemic type of stroke with (96%) of them surviving (mortality rate (4%) while at Bugando medical centre no patient underwent a CT scan and so they were tested based on the clinical symptoms they presented with to determine if they had either ischemic or hemorrhagic type of stroke. (22%) patients presented with symptoms suggestive of hemorrhagic stroke and (78%) were likely ischemic with the overall survival rate of (44%) (Mortality rate 56%). A case fatality rate for hemorrhagic type at Bugando medical centre was 62% and case fatality at Bugando medical centre for ischemic type was 54%.

Conclusion: Stroke at Bugando medical centre afflicts people at a lower age (36>X<55) most of them either employed or peasants than Julius – Maximillian University Hospital of Wurzburg where most patients are old (>65) and retired. While at Bugando medical centre seems to be familial linked, in Julius – Maximillian University Hospital of Wurzburg is likely to be a result of life style as the factors such as smoking, obesity and high cholesterol level were more predominant.