Stroke emerges a great threat to young adults

Monday July 22 2019

 

By John Namkwahe @johnteck3 jnamkwahe@thecitizen.co.tz

It started with abnormal pain in his back that prompted Zabron Mababula, 43, resident of Songea to consult a doctor at Peramiho hospital back in November 2017.

“I used to sit for many hours on a chair while working at the office. I am an accountant so I was confined to working on a computer non-stop throughout the day and sometimes, I even skipped breakfast and lunch breaks,” Zabron narrates to Your Health in an exclusive interview.

The doctor at the hospital instructed him to avoid sitting on a chair for too long, especially with a desk job and advised him to join a physiotherapy programme at the hospital to treat the lower back pain.

“I found the programme very useful because the back pain disappeared eventually,” says Zabron.

A father of two and a public servant recalls that after recovering from severe lower back pain, he resumed office duties.

But later in October 2018, he started experiencing difficulty in walking accompanied by severe headache with no known cause—common warning signs of a stroke.

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“The symptoms started after I collided with an opposing player during a football match. Then I experienced loss of balance,” he tells Your Health.

In February 2019, he went back to the hospital, but this time the condition didn’t go away, prompting him to seek further medical assistance at another hospital—Ikonda hospital in Njombe district.

The hospital results showed that he suffered spinal disc damage—the situation leads to lower back pain, leg pain and other symptoms such as numbness and weakness, according to medical sources.

“I was prescribed to use Vitamin B and D tablets to recover the damage. Eventually, I recovered and resumed office works,” Mr Zabron tells.

Mr Zabron is currently seeking further specialised medical treatment at Muhimbili National Hospital-Mloganzila in Dar es Salaam, after succumbing a stroke disease.

“I came to Dar es Salaam for a work meeting which was scheduled to be held on Sunday and Monday,” says Zabron.

He narrates that on Sunday morning while he was preparing to attend the meeting, he accidentally hit his right foot on stairs and lost his balance.

“I experienced severe leg pain that persisted for 10 minutes and later felt tingling in the right feet. I could not move so I stood up after 20 minutes,” Zabron tells.

He later managed to walk inside the house, but after a few minutes the condition worsened and he could not attend the meeting.

On the same day, Mr Zabron, accompanied by his young brother Mresi, went to MNH in Mloganzila but he didn’t receive treatment because the specialist was not on duty.

Therefore, they returned to the hospital on Monday whereby Zabron managed to undergo CT scan and magnetic resonance imaging (MRI) and when the results came out, he was diagnosed with minor stroke that necessitated prolonged medication.

The patient waiting area at the Neurology Department located on the first floor of the hospital building was overwhelmed with over 30 patients suffering from different neurological diseases including stroke.

One could easily notice that the patients were attending a clinic session at the hospital as they were spotted being summoned one by one to see the doctor at the consultation room.

Some of the patients were on the wheelchair and others seated on hospital benches awaiting their turns to see the doctor.

Zabron was one among the young adult patients in the queue, and others were older adults accompanied by their relatives.

At his age, he represents millions of Tanzania’s young adults aged below 45 years who are at high risk of developing Non-Communicable Disease (NCDs) such as stroke disease, according to local specialists.

Stroke affects young adults too

This follows a local study that was presented during the 7th Muhimbili University of Health and Allied Sciences (Muhas) Scientific Conference indicating the alarming prevalence of stroke in young adults.

The study titled, “Stroke in Young Adults admitted at MUHAS Academic Medical Centre in Tanzania: A Comparison with Older Adults,” involved 1403 patients admitted at Muhas Academic Medical Centre in Dar es Salaam. It indicated that out of 369 patients recently diagnosed with a stroke, 123 were younger adults, whereas the remaining were older adults.

A stroke is the rapid loss of brain function(s) due to a disturbance in the blood supply to the brain. This can happen because of lack of blood flow caused by a blockage or a leakage of blood, according to medical sources.

The study served to determine the magnitude of stroke and describe stroke sub-types, risk factors and outcomes in young adults aged below 45 years compared to older adults aged above 45 years in Tanzania.

The lead author of the study which was carried out from June 2018 to January 2019, Dr Sarah Matuja, from Department of Internal Medicine at Muhas said stroke was popularly believed to be a condition affecting the elderly.

The study indicates further that 68 stroke patients were female younger adults (55.3 per cent) and 138 (56. 1 per cent) were female older adults.

Furthermore, the study shows that younger adults were more likely to be current alcohol consumers and unmarried, also 10.2 per cent of the older adults diagnosed with stroke were alcohol consumers.

Ms Naomi Edson, Nurse Officer at the neurology department at MNH, tells Your Health that clinic session takes place twice a week--on Tuesday and Thursday involving patients diagnosed with neurological diseases including strokes.

“The number of patients attending the clinic keeps changing. Last Tuesday, 30 patients and today (Thursday) 30 have attended, but more are still coming,” says Naomi.

According to Naomi, during the previous clinic session on Tuesday, 17 out of 30 neurological patients were young adults aged below 45 years including stroke patients.

“Today until this hour, 13 out of 30 neurological patients who have attended the clinic are young adults,” says Ms Naomi.

Normally the clinic session at the hospital starts at 9 am and ends at 3 pm, but sometimes the hospital’s specialists are forced to continue attending the patients even after the clinic session time is over, according to Naomi.

“This happens when there is still a number of patients in the queue waiting to see the doctor,” says Naomi.

Risk factors

Dr Leonard Msango, a Neurophysician at MNH tells Your Health that high blood pressure (hypertension) is one the most common causes of stroke.

“Other risk factors include tobacco smoking, obesity, diabetes, use of illicit drugs, hormonal contraception, HIV infection and sickle cell disease,” says Dr Msango.

Current epidemiological data suggests that strokes are occurring at a younger age. As many as 1 out of every 6 strokes occurs in a young adult (18 to 50 years old). Heterogeneity in incidence rates, stroke subtypes, and aetiology among younger stroke victims in both developed and developing countries is often noted.

The ischemic stroke [when the arteries to your brain become narrowed or blocked] in the young poses many challenges such as premature death and years of healthy life lost attributed to a disability, according to medical sources.

“A stroke often requires emergency care. Chronic stroke can lead to either death or disability. Minor stroke can be cured. Succumbing a stroke at a young age has social and economic repercussions,” says Dr Msango.

Prevention

According to Dr Msango, prevention for stroke includes decreasing the risk factors such as abandoning tobacco smoking, eating healthy food and engaging in physical exercise, to mention a few.

World Health Organisation (WHO) estimates that more than 17.5 million people died of cardiovascular diseases such as heart attack or stroke in 2012.

Contrary to popular belief, more than 3 out of 4 of these deaths occurred in low- and middle-income countries, and men and women were equally affected.

The good news, however, is that 80 per cent of premature heart attacks and strokes are preventable. Healthy diet, regular physical activity, and not using tobacco products are the keys to prevention. Checking and controlling risk factors for heart disease and stroke such as high blood pressure, high cholesterol and high blood sugar or diabetes is also very important.

Eat a healthy diet: A balanced diet is crucial to a healthy heart and circulation system. This should include plenty of fruit and vegetables, whole grains, lean meat, fish and pulses with restricted salt, sugar and fat intake. Alcohol should also be used in moderation.

Take regular physical activity: At least 30 minutes of regular physical activity every day helps to maintain cardiovascular fitness; at least 60 minutes on most days of the week helps to maintain healthy weight.

Avoid tobacco use: Tobacco in every form is very harmful to health - cigarettes, cigars, pipes, or chewable tobacco. Exposure to second-hand tobacco smoke is also dangerous. The risk of heart attack and stroke starts to drop immediately after a person stops using tobacco products, and can drop by as much as half after 1 year.

Check and control your overall cardiovascular risk: An important aspect of preventing heart attacks and strokes is by providing treatment and counselling to individuals at high risk (those with a 10 year cardiovascular risk equal to or above 30%) and reducing their cardiovascular risk.

A health worker can estimate your cardiovascular risk using simple risk charts and provide the appropriate advice for managing your risk factors. Know your blood pressure: High blood pressure usually has no symptoms, but is one of the biggest causes of sudden stroke or heart attack.

Have your blood pressure checked and know your numbers. If it is high, you will need to change your lifestyle to incorporate a healthy diet with less salt intake and increase physical activity, and may need medications to control your blood pressure.

Additional information from WHO.

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