UK Stroke Forum 2025 | Leadership in global stroke care: insights from services implemented in Tanzania

So basically my talk was on leadership in global stroke care and how my leadership journey in stroke started was based on clinical curiosity and observation which was back in 2016 and 2019 when I was doing my internal medicine specialty training. We were seeing an increase in the number of stroke cases within the young adult population between 18 to 45. But we didn’t really have statistics to account for the hypothesis we were seeing, the admissions that we were seeing. So I conducted a prospective cohort study back then, looking at the burden of stroke in young adults and comparing the burden with the older counterparts. And we found really alarming results because we saw that among the stroke admissions at that particular point in time a quarter of them comprised the young adult population and the leading risk factor was poorly treated hypertension and within 30 days half of these young strokes had died which is really taking a toll in our country because nationally more than 30% of the population comprises the young adult population. So this is really alarming. Now, based on the findings that we got from our study, it built momentum and sparked curiosity that we really need to improve stroke care in the country. Now, when I joined faculty back in 2020 at the teaching institution where I work, that is in the northwestern part of Tanzania. Again, I was working in the neurology unit where 80% of all neurological admissions were stroke, but we didn’t really have data to account for the admissions, monthly admissions, monthly mortality, and then how can we improve practice? So I initiated the first digital inpatient stroke registry in Tanzania, which was single-center. Of course, I didn’t have funds. So all I could leverage on were students who I was working with, who had interest in research, but also interest in neurology. I also had mentors supporting the agenda. And yeah, so I built on just using a small team. And then over time, and remember by then, there was also the COVID pandemic. So it was a really stressful time, but we were able to pull through. And I was able to also secure some funding, which came in later, to further strengthen the registry that we started. Now, the registry really was a foundation to improving national stroke efforts in the country. We’ve had several publications based just from the registry that we started, not just for myself, but also the mentees I was mentoring. They also built their skills using the awards and the grants that we received. Now through some of the awards that I received, including the WSO Future Stroke Leaders a program grant which supported the implementation of acute stroke services in the region so one of the issues that we did was improve by comprehensively creating stroke registries not just at the single center but we expanded the services to other large tertiary hospitals aiming at developing a national stroke registry we were able to train stroke multidisciplinary teams we develop protocols and pathways. So you could clearly see that it was a journey that had a vision right so eventually we were able to establish stroke units which we see now that we currently see have significantly reduced mortality and disability. But most importantly, we have also begun giving acute therapies to patients presenting with acute ischemic stroke within the window period. This is something that is a national achievement. So far, countrywide, we’ve been able to treat seven cases successfully by the thrombolytic therapy that has been donated to us through the WSO collaboration.

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