Quality of life after first-ever stroke: An interviewbased study from Blantyre, Malawi

Background In post-stroke patients, impairment of quality of life (QOL) has been associated with functional impairment, age, anxiety, depression, and fatigue. Good social support, higher education, and better socioeconomic status are associated with better QOL among stroke survivors. In Africa, studies from Nigeria and Tanzania have reported on post-stroke QOL. Aim The aim of this study was to describe QOL more than six months after first-ever stroke in Malawi. Methods This was an interview-based study about a stroke-surviving cohort. Adult patients were interviewed six or twelve months after their first ever stroke. HIV status, modified stroke severity scale (mNIHSS) score, and brain scan results were recorded during the acute phase of stroke. At the time of the interviews, the modified Rankin scale (mRS) was used to assess functional outcome. The interviews applied the Newcastle Stroke-specific Quality of Life Measure (NEWSQOL). All the data were analysed using Statview™: the X2 test compared proportions, Student’s t-test compared means for normally distributed data, and the Kruskal-Wallis test was used for nonparametric data. Results Eighty-one patients were followed up at least six months after the acute stroke. Twenty-five stroke patients (ten women) were interviewed with the NEWSQOL questionnaire. Good functional outcome (lower mRS score) was positively associated with better QOL in the domains of activities of daily living (ADL)/self-care (p = 0.0024) and communication (p = 0.031). Women scored worse in the fatigue (p = 0.0081) and cognition (p = 0.048) domains. Older age was associated with worse QOL in the ADL (p = 0.0122) domain. Seven patients were HIV-seroreactive. HIV infection did not affect post-stroke QOL. Conclusion In Malawi, within specific domains, QOL after stroke appeared to be related to patients’ age, sex, and functional recovery in this small sample of patients.

Regional Disparities in Sedentary Behaviors and Meal Frequency in Iranian Adolescents: The CASPIAN-III Study

Background: The prevalence of obesity is increasing among Iranian youngsters like other developing countries. Objectives: This study was conducted to assess regional disparities in sedentary behaviors and meal frequency in Iranian adolescents. Patients and Methods: In this national survey, 5682 students aged 10 - 18 years from urban and rural districts of 27 provinces of Iran were selected via stratified multi-stage sampling method. The country was classified into four sub-national regions, based on criteria of the combination of geography and socioeconomic status (SES). Mean of meal frequency and physical activity levels as well as prevalence of omitting meals and sedentary behavior were compared across regions with different SES after stratifying with sex and age group. Results: Meal frequency in lower socio-economic regions was significantly higher than two other regions in 10 - 13 and 10 - 18 years old groups (P trend < 0.001). However, the mean of working hours with computer was linearly increased with increasing the SES in studied regions (P trend < 0.001), whereas the corresponding figure was not significant for the mean of watching TV (P trend > 0.05). Frequency of adolescents omitting their meals was higher in higher SES regions especially in West Iran (P < 0.001) in 10 - 13 years old age group. Having personal computer and working with it more than two hours per day mainly was observed in central Iran which ranked as the highest SES group. Conclusions: Efforts to ensure Iranian youth meet healthy food habits and screen time guidelines include limiting access to screen technologies and encouraging parents to monitor their own screen time is required.