Mortality and morbidity among hospitalized adult patients with neurological diseases in Cameroon

Kompoliti, Katie; Jacques, Denis; Mapoure, Yacoumba Njankouo; Nyinyikua, T.; Ouyang, Bo; Shah, Hiral; Calvo, Sara; Fernandez-Sierra, Abel; Delgado, M.E. Cubo

doi:10.1016/j.jns.2017.08.3245

Cited by 14 publications

(17 citation statements)

References 8 publications

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“…Few studies in sub-Saharan Africa have reported the distribution of neurological diagnoses among inpatients with neurological illness admitted to a neurology ward and only one study reported predictors of mortality. One retrospective study from Cameroon found a similar mortality rate (19%) to that in our study with greatest mortality among those with stroke diagnoses (53%) [21]. Only one prospective study was identified in the literature reporting prevalence of neurological diagnoses in hospitalized patients in Congo, with a lower prevalence of stroke than that in our study (6.6% stroke) which may have been underestimated as there was no access to imaging [24].…”

Section: Discussionsupporting

confidence: 69%

“…Several studies have analyzed the prevalence of neurologic illness within sub-Saharan Africa, many of which are community survey studies [4,11,18,21,30,34]. This is the first report of the distribution of neurologic diagnoses and in-hospital mortality in a Ugandan neurology ward.…”

Section: Discussionmentioning

confidence: 99%

“…While there is a pronounced need to describe the prevalence of neurological illness and identify predictors of mortality associated with these diagnoses in healthcare settings throughout Uganda and other sub-Saharan countries, electronic health record (EHR) systems, and hence, administrative data, are not widely available to aid in such endeavors. Several studies have analyzed in-hospital mortality rates and associated factors in various sub-Saharan African countries, with no prior work analyzing inhospital mortality among patients admitted to a neurology ward particularly within Uganda [4,21,24,25,30,34]. Understanding the prevalence and identifying high-risk causes of mortality is critical for healthcare providers and policy makers to prioritize public health, clinical, and quality improvement interventions.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of and Characteristics Associated with In-Hospital Mortality in a Ugandan Neurology Ward

Diaz

Fenton

et al. 2020

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Background ― While the burden of neurologic illness in developing countries is increasing, less is known about mortality among patients admitted to sub-Saharan African hospitals with neurologic disease. We sought to characterize the rate and patient-level predictors of in-hospital mortality in a Ugandan Neurology ward.ccMethods ― Data was prospectively collected on 335 patients admitted to the Neurology ward of Mulago Hospital, Kampala, Uganda. Kaplan-Meier survival curves and multivariate COX proportional hazard modeling were used to assess survival.Results ―Within our sample (n=307), 35.8% received no diagnosis at time of hospital admission. Stroke (27.3%), head trauma (19.6%), and malaria (16.0%) were the most common diagnoses. Among the 56 (18.5%) patients who died during the index hospitalization, the most common diagnosis at admission and at death was stroke. Adjusted regression analysis showed that patients without a diagnosis at time of death (HR=7.01 [2.42-20.35], p<.001) and those with diagnoses of infections (HR=5.21 [2.16-12.58], p=<.001), stroke (HR=2.69 [1.20-6.04], p=.017), or head trauma (HR=3.39, [1.27-9.07], p=0.15) had worse survival. Conclusions ― In-hospital mortality affected nearly 20% of the cohort, with worse survival among those without a diagnosis and with infections, stroke, head trauma. Future work should identify reasons for increased mortality among these high-risk groups and implement targeted interventions.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence of and Characteristics Associated with In-Hospital Mortality in a Ugandan Neurology Ward

Diaz

Fenton

et al. 2020

Preprint

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“…Interestingly, we have previously published a separate analysis for disability and death, and found that higher educational level was associated with decreased likelihood of disability. [16] To explain this finding several hypotheses can be taken into account such as the fact that higher educational level is usually associated with higher socioeconomic status and healthier life style, which may lead to a decrease cerebrovascular risk factors, or earlier recognition of stroke symptomatology and thus earlier intervention. However, this information cannot be extrapolated to the overall community due to selection bias with a large proportion of disability missing data especially from the rural area, lack of information regarding long-term disability, and the limited reliability of the operative definition for disability used in this study.…”

Section: Discussionmentioning

confidence: 99%

“…[22] A detailed analysis about the neurological diseases and risk factors associated with death and disability in this cohort has been published elsewhere. [16].…”

Section: Discussionmentioning

confidence: 99%

Neurological Disease Surveillance in Cameroon, a Rural and Urban-Based Inout Patient Population Study

Jacques¹

2019

CNN

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Background: There is a paucity of literature on the burden of neurological diseases in sub-Saharan Africa.Objective: To create a registry and surveillance of neurological diseases from urban and rural health centers in Cameroon. Methods: Retrospective review of medical records of inpatients and outpatients from two urban public hospitals in Douala and two rural health care centers, from 2013 to 2015 was conducted. In the urban areas, the diagnosis was made by a neurologist but this was not the case in the rural areas. The following variables were analyzed: demographics, medical center characteristics, presenting neurological complaint, medical history, neurological diagnosis, death and disability. Neurological diseases were classified according to ICD-10. Results: Out of 20,131 medical charts available (13% from the rural area), 4,187 cases (20.7%) with neurological complaints were identified and reviewed, mean age 48.67 + 18.62 years, females 54.7%, 188 children (4.4%). The most frequent neurological complaints were: paresis/weakness (G.82, 25.2%) and headache (R.51, 22.0%). The most common concurrent medical history was hypertension (I10, 40.0%), and HIV (B20, 16.45%). The most common neurological diagnoses were cerebrovascular disease (G45, G46, 51.5%), and infection (B50, G00, G04, G06, 24.13%) in adults, and epilepsy (G40, 64.0%) in children. Death due to neurological cause was recorded in 428 patients (19.1%), and disability in 1,072 (57.2%). Neurodegenerative diseases were exclusively diagnosed in urban areas. Conclusion: Population aging and changes in the distribution of risk factors have accelerated the prevalence of non-communicable diseases such as cerebrovascular disease. However, additional work to characterize the nature of diagnosis, treatment and care is important to advance quality of care in the adult and pediatric neurological disorders. A health policy geared towards prevention and neurological training for health professionals is warranted.

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Pattern and frequency of neurological and neurosurgical care of adult inpatients and outpatients at a tertiary referral hospital in Kenya

et al. 2020

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Objective To describe the patterns and burden of neurological and neurosurgical disorders at a national tertiary level referral hospital in western Kenya. Methods We conducted a three-month period prevalence study. We recruited consecutive adult patients seeking neurological-neurosurgical care in both inpatient and outpatient settings at Moi Teaching and Referral Hospital. Results 833 participants were included. The age range was between 19 year and 99 years (mean age = 45.3 years). The most common diagnoses among neurology inpatients were meningitis (12%), ischemic stroke (11.0%) and epilepsy/seizure (6.7%). Among neurology outpatients, epilepsy (35.1%) and ischemic stroke (18.8%) were the most common diagnoses. The most common neurosurgery inpatient diagnosis was hemorrhagic stroke (16.3%) and among outpatients, the most common diagnoses were traumatic brain injury (17.4%) and hemorrhagic stroke (16.3%). Overall, 471 (56.5%) patients underwent HIV testing, of which, 89 (18.9%) were HIV positive and 382 (81.1%) were HIV negative. Thirty-one inpatient deaths (male 58%), attributable to neurological and neurosurgical disorders, occurred during the study period. Meningitis was the most common cause of death. Conclusions The findings suggest that meningitis, stroke, epilepsy, and traumatic brain injury were the most common diagnosis. More resources and efforts should be directed towards prevention, diagnosis and management of these conditions in the region.

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Mortality and morbidity among hospitalized adult patients with neurological diseases in Cameroon

Cited by 14 publications

References 8 publications

Prevalence of and Characteristics Associated with In-Hospital Mortality in a Ugandan Neurology Ward

Prevalence of and Characteristics Associated with In-Hospital Mortality in a Ugandan Neurology Ward

Neurological Disease Surveillance in Cameroon, a Rural and Urban-Based Inout Patient Population Study

Pattern and frequency of neurological and neurosurgical care of adult inpatients and outpatients at a tertiary referral hospital in Kenya

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