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.
For more information on supporting the
partnership please visit:
