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Background and Aims: Stroke is the leading cause of disability and the second most common cause of death after ischemic heart disease worldwide. Understanding predictors of early poststroke mortality provides opportunities for interventions and favorable outcomes. This study aimed to determine the incidence and predictors of 30‐day mortality among patients admitted with the first stroke at referral hospitals in Dodoma. Methods: A prospective longitudinal observational design enrolled patients with acute stroke confirmed by CT scan or MRI admitted at referral hospitals in Dodoma. The National Institute of Health Stroke Scale was used to assess stroke severity at baseline. A comparison of risk factors, clinical profiles, and mortality was done using the Chi‐square test. A logistic regression model was used to determine the predictors of 30‐day mortality in patients with the stroke while the 30‐day probability of survival was estimated using Kaplan−Meier analysis. Results: Out of 226 patients with first‐ever stroke, 121(54%) were males, and the population mean age was 63(15) years. The 140(62%) had Ischemic stroke, and 154(68%) survived at the 30th day. Patients with a history of smoking 2.4 [95% confidence interval (CI) (1.0−5.6), p = 0.048], loss of consciousness 2.7 [95% CI (1.2−6.4; p = 0.019] and unequal pupil size 13.7 [95% CI (4.1−58.1, p < 0.001 were significantly more associated with mortality within 30 days. The median survival was 7 (3−9) days, whereas alcohol drinkers and those aged above 60 years had a shorter time to mortality compared to non‐alcohol drinkers and those aged <60 years. Conclusion: The study showed a high incidence of mortality within 30 days after the first stroke episode, with the highest proportion dying within 7 days of being hospitalized. Advanced age of ≥60 years, smoking, alcohol use, and severe stroke at admission warrant special attention. [ABSTRACT FROM AUTHOR]

Key clinical message: Neuromyelitis optica spectrum disorder is an autoimmune disease, rarely presents with antiphospholipid syndrome. Diagnosis and management of NMOSD are challenging in the background of diverse presentations, especially in resource‐limited settings. Neuromyelitis optica spectrum disorder (NMOSD) is a progressive demyelinating autoimmune condition resulting from the autoantibodies produced against aquaporin‐4 (AQP‐4) proteins which are widely distributed in astrocytes in the nervous system. In the setting of NMOSD, it is very crucial to consider other autoimmune diseases as differential diagnoses or co‐occurrences due to the diversity of symptoms. NMOSD co‐exists with other autoimmune diseases such as myasthenia gravis, thyroid disease, ankylosing spondylitis, pernicious anemia, thrombotic thrombocytopenic purpura, ulcerative colitis, and systemic lupus erythematosus. Few cases of antiphospholipid syndrome co‐existing with NMOSD have been reported. In resource‐limited settings, the published data are scarce, and therefore, autoimmune diseases are poorly studied. Therefore, late diagnosis and delayed treatment initiation pose long‐term sequelae and hence poor prognosis. Here, we present a case of an African woman in her early 40s presenting with bilateral progressive loss of vision, transverse myelitis, extensive longitudinal hyperintense T2 cervical lesion, and AQP‐4 autoantibody keeping with NMOSD. The co‐existence of antiphospholipid syndrome, in this case, was supported by a history of recurrent pregnancy loss and positive antiphospholipid antibodies. This case underscores the importance of individualized‐based medicine, especially in resource‐limited settings. [ABSTRACT FROM AUTHOR]

The objective of this quasi-experimental study is to assess the risk factors and early cardiovascular outcomes in cancer patients treated with anthracycline-based chemotherapy in Tanzania. The study will be conducted at Ocean Road Cancer Institute in Dar es salaam, Tanzania. The study will have three phases: baseline survey, follow-up, and end-line survey. Participants will be newly diagnosed adult cancer patients who are eligible for anthracycline-based chemotherapy. A total of 427 participants will be involved. At baseline, participants will be evaluated for the cardiovascular risk factors before commencing chemotherapy. During follow-up, participants will commence their prescribed anthracycline and the cardiovascular indices monitored throughout until the patient completes the prescribed anthracycline cycles. After completing the prescribed anthracycline cycles, an end line survey will be conducted to evaluate any change in cardiovascular indices. The outcome variable in this study will be the change in biochemical data (high-density lipoprotein, low-density lipoprotein, triglyceride, and troponin I), blood pressure, and electrocardiographic information (heart rate and Bazett QT interval). Independent variables will be demographic characteristics, risk factors for cardiovascular disorders, current dietary practices, and body mass index. Descriptive statistics will be used to describe the participants. Independent and paired t -tests will be performed to make comparisons between and within groups. P -values <0.05 will be considered statistically significant. The results of this study will help clinicians and policymakers to understand the burden of early cardiovascular outcomes and plan for appropriate preventive strategies. [ABSTRACT FROM AUTHOR]

Background: Malaria and acute bacterial meningitis (ABM) are the leading infectious causes of febrile encephalopathy in malaria endemic settings. The clinical distinction of the two conditions is complicated by overlap in clinical features.Objective: To determine the clinical predictors for malaria, ABM and treatment outcome in febrile children aged 2 months to 12 years with altered mentation at two tertiary hospitals in Northwestern Tanzania.Methods: Prospective study of 103 children to document demographic data and physical examination findings, such as level of consciousness and meningeal irritations. Laboratory results for cerebrospinal fluid, hemoglobin, malaria and HIV were also evaluated.Results: Age >60 months and hemoglobin ≤5 g/dl were independent predictors of malaria; (p = 0.013 and 0.004, respectively). HIV infection was the only predictor of meningitis, p = 0.037, and mortality was high if the diagnosis was unconfirmed.Conclusions: Children with febrile encephalopathy are more likely to have malaria than ABM if they have severe anemia. [ABSTRACT FROM AUTHOR]