Browsing by Author "Namale, Alice"

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A Descriptive Epidemiological Study on Stroke in Kampala, Uganda: A Hospital Based Study
(Pan African Association of Neurological Sciences, 2012) Nakibuuka, Jane; Nyakoojo, Abwooli; Namale, Alice; Blondin, Nicholas A.; Ddumba, Edward
Background Basic stroke features are hardly known in sub-Saharan countries, and no data are available in Uganda. Objective To characterize patients presenting with clinical stroke to Mulago Hospital. Design Descriptive epidemiological study. Setting Mulago National referral Hospital in Kampala, Uganda. Participants Patients presenting with clinical stroke from 1st July to 30th November 2006. Patients with confirmed stroke had comprehensive assessments for stroke risk factors. Results Among 139 patients presenting with clinical stroke, 127 had a non-contrast head CT scan and 12 died prior to scan. Eighty five patients were confirmed to have stroke while 42 had non stroke lesions. Among patients with confirmed stroke, 77.6% had ischemic stroke while 22.4% had hemorrhagic stroke. The mean age for all stroke patients was 62.2 ± 16.2 yrs and 51.8% were men. The incidence of both ischemic and hemorrhagic stroke increased with age. Atherosclerotic stroke was the most common ischemic stroke etiology, observed in 43.5% patients with ischemic stroke, while intraparenchymal hemorrhage was the most common hemorrhagic stroke etiology, observed in 78.9% of patients with hemorrhagic stroke. Hypertension was the commonest risk factor with more than 50% of all stroke patients reporting a history of hypertension, and more than half found to have blood pressure greater than 140/90 mm Hg. Physical inactivity and hypercholesterolemia were encountered in more than 36% and 30% of patients with ischemic and haemorrhagic strokes respectively.
Utility of Transthoracic Echocardiography and Carotid Doppler Ultrasound in Differential Diagnosis and Management of Ischemic Stroke in a Developing Country
(National Center for Biotechnology Information (NCBI), 2014-04-17) Nakibuuka, Jane; Nyakoojo, B. Wilson; Namale, Alice; Ddumba, Edward; Leontsini, Elli; Nuwaha, Fred
Objective—We sought to describe findings, diagnostic yield, cost effectiveness of transthoracic echocardiography (TEE) and Carotid doppler ultrasound (CDU) in ischemic stroke. Methods—Cross sectional study at Mulago hospital, Uganda. Institutional ethical approval, patient consent was obtained. Patients eighteen years and above with ischemic stroke confirmed by brain computerized tomography (CT) scan and met inclusion criteria were selected. TTE and CDU were done as part of comprehensive assessment for stroke risk factors. Data was analyzed using SPSS 14. Univariate analysis was done for social-demographics, abnormalities on cardiac imaging and diagnostic yield using TOAST criteria. Bivariate analysis for association between stroke risk factors, cardio-embolic stroke and other ischemic subtypes (diagnosed using clinical and CT scan features). Statistical significance was set at P<0.05. Results—Of 139 screened patients with suspected stroke, 127 underwent brain CT scan as 12 died before CT. Eighty five were confirmed stroke by CT scan with 66 (77.6%) ischemic stroke, mean age 62 years (SD+16.6), 53% were male. Out of 66, 62 (93.9%) underwent both TTE and CDU. Although only 7 (11.3%) reported history of heart disease, 43 (69.3%) had abnormal findings on TTE with left atrial enlargement commonest in 21 (48.8%). Thirty eight (61.3%) had abnormal finding on CDU with atherosclerosis commonest in 28 (45.2%). Using clinical and CT scan features, atherosclerotic stroke was the commonest subtype in 29 (46.8%) then cardio embolic 18 (27.3%). Only 6 (9.7%) patients had abnormal findings on TTE suggesting possible cardio-embolism by TOAST criteria. None had stenosis >50% on CDU. Multiple valvular lesions P<0.001, severe valvular lesions P=0.001 were associated with cardio-embolic stroke. Conclusions—Majority of ischemic stroke patients without previous history of heart disease had abnormal findings on TTE and CDU. Diagnostic yield for cardio-embolic stroke by TOAST criteria was very low given the high cost involved for a developing country.