Improving the consent process for neuroepidemiologic research in resource-poor settings

Meta, Judith; Nasuwa, Fortunata; Mwendo, Emanuel; Reyburn, Hugh; Bower, James H.

doi:10.1212/wnl.0000000000000184

Cited by 1 publication

(2 citation statements)

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“…There were no refusals to participate in the study which is not atypical for the region. 20 The confirmed 90-day mortality was high at 43% (75/176 patients), although an additional 20 participants (11%) of enrolled participants were lost to follow-up, making the true mortality at 90 days likely even higher. During the follow-up telephone interview by investigators, 81 participants or their proxies responded to the Berkman Syme Social Network Index, PHQ-9, and mRS.…”

Section: Results Enrollmentmentioning

confidence: 93%

“…153 participants had CT scans confirming the diagnosis of stroke (ischemic stroke n=80; hemorrhagic stroke n=96). There were no refusals to participate in the study which is not atypical for the region [20]. The confirmed 90-day mortality was high at 43% (75/176 patients), although an additional 20 participants (11%) of enrolled participants were lost to follow up, making the true mortality at 90 days likely even higher.…”

Section: Resultsmentioning

confidence: 99%

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Post-stroke social networks, depressive symptoms, and disability in Tanzania: A prospective study

Saadi

Okeng'o

Biseko

et al. 2018

International Journal of Stroke

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Background Evidence suggests that social networks improve functional recovery after stroke, but this work has not been extended to low- and middle-income countries (LMICs). Post-stroke depression interferes with functional outcome but is understudied in LMICs. Aims To determine the relationships between social networks, disability, and depressive symptoms in patients surviving 90-days post-stroke in Dar es Salaam, Tanzania. Methods Participants ≥ 18 years, admitted ≤ 14 days of stroke onset, were enrolled. Disability was measured using the modified Rankin Scale, social networks by the Berkman-Syme social network index, and depressive symptoms by the Patient Health Questionnaire-9 (PHQ-9) by telephone interview at 90 days. A Kruskal-Wallis test or Spearman's correlation coefficient was used to assess the associations between social networks, depressive symptoms, and disability. Results Of 176 participants, 43% (n = 75) died, with an additional 11% (n = 20) lost to follow-up by 90 days. Among 81 survivors, 94% (n = 76, 57% male, average age 54 years) had complete information on all scales (mean and median follow-up time of 101 and 88 days). Thirty percent (n = 23, 41.9%, 95% confidence interval 20.2) had at least mild depressive symptoms (PHQ-9 ≥ 5 points). Nearly two-thirds (n = 46, 61%) reported ≥ 3 close friends. A higher social network index score was associated with fewer depressive symptoms (p < 0.0001) and showed a trend towards significance with lower disability (p = 0.061). Higher depressive symptom burden was correlated with higher disability (r = 0.52, p < 0.0001). Conclusion Post-stroke social isolation is associated with more depressive symptoms in Tanzania. Understanding social networks and the associated mechanisms of recovery in stroke is especially relevant in the context of limited resources.

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Section: Results Enrollmentmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%