A description of functional needs of community-dwelling stroke survivors in Rwanda: a prospective observational cohort study

PURPOSE: Stroke survivors in low- and middle-income countries have different needs compared to those in high-income countries. Our aim was to describe the unmet functional needs of Rwandan stroke survivors at discharge and three months after stroke. METHODS: A study using an adapted modified Needs Assessment Questionnaire (mNAQ) was conducted at six hospitals in Rwanda. Moderate or severe needs are described using descriptive statistics and logistic regression models. RESULTS: A total of 337 participants, with a mean age of 61 years, were recruited. Most were female (59%), and 70% had an ischemic stroke, while 71% had hypertension. At discharge, 97% of participants had moderate to severe needs. Follow-up at three months was available for 78% of participants and 22% died. At three months, over 70% of participants continued to have moderate to severe needs. CONCLUSIONS: Almost all Rwandan stroke survivors have moderate to severe needs and disability at the time of discharge, and for those that survive, over 70% continue to have moderate to severe needs at 3 months. This estimate is much higher than previously reported. Improving functioning in the community is essential for Rwandan stroke survivors.