The Malawi Stroke Unit Team has a goal to provide a cost-effective stroke unit that will help revolutionise the lives of people in Malawi that are affected by the implications of stroke.
University College London Hospitals has partnered with Queen Elizabeth Central Hospital, Blantyre, Malawi, the Malawian government, Liverpool University (via the Wellcome Institute in Malawi), and UCL, to build and then run a stroke unit.
The UK team are helping to plan the unit, helping to develop the unit operational systems and will help train the staff, but the unit itself will be led and run by the Malawian clinical team. The aim of the partnership is to develop a sustainable model for stroke care in Malawi. Currently there are no stroke units at all in the country, but very high rates of stroke incidence and stroke related death.
Stroke is a common presentation at Queen Elizabeth Central Hospital and is in the top five reasons for hospital admission and top three reasons for in-hospital mortality (SPINE 2012 analysis). Malawi currently has a poor stroke outcome compared to its neighbouring countries, with local data showing that nearly 40% of people having a stroke die at six months.
Specific risk factors for death are increased stroke severity, advanced immunosuppression from HIV infection and age. The former two risk factors are potentially preventable with easily achievable intervention such as early swallow screen, immediate therapy (where guardians could be trained to deliver this), close vigilance for infections whether it be central nervous system infections, aspiration pneumonia or urinary tract infections, and initiating and maintaining secondary preventative treatment.
The target over the next 10 years is to deliver a seven-bedded stroke unit that is embedded within Queen Elizabeth Central Hospital. This unit will serve as a national centre of excellence for delivery of stroke care, training and research to further inform best practice, and ultimately improve the burden of stroke in Malawi. The aim is also to ensure that the stroke unit is culturally appropriate and sensitive to the limited resources available in Malawi.
This partnership offers collaborative opportunities for the stroke multi-disciplinary team, both in the UK and Malawi. Thanks to funds from TNM (a Malawian telecommunications company), construction of the building has already begun and is scheduled for completion by Autumn 2019 along with an ongoing training and exchange programme.
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