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Psychosocial and Economic Evaluation of Stroke Management in the Elderly: A Prospective Study at the Neurology Department in a Hospital in Dakar, Senegal

Received: 5 April 2021    Accepted: 19 April 2021    Published: 29 April 2021
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Abstract

Stroke is the second leading cause of death worldwide and the leading cause of physical disability in the elderly. The objective of the study was to evaluate the psychosocial and economic aspects of its management. We conducted a cross-sectional, descriptive and evaluative study at the neuroscience clinic of FANN National University Hospital from May 8 to August 8, 2019. It involved 60 people aged 60 years and over received in consultation as well as 59 family caregivers who gave their consent. The caregivers' suffering was evaluated using the MINI ZARIT grid consisting of 5 items for a total score ranging from 0 to 7. The psychological impact of the disease was evaluated by the Geriatric Depression Scale in its short version (GDS); composed of 15 items scored from 0 to 1. The direct and indirect financial cost was evaluated on two items: The estimated financial loss associated with the work stoppage estimated by the daily earnings of the primary caregiver. Travel costs related to transportation from home to the neurovascular consultation unit. The mean age of our patients was 71.46 years (standard deviation 7.79 years). Females predominated with a sex ratio of 0.71. Most of our patients were polygamous (38.30%), followed by widowers (35%). Most of the patients had attended Koranic school (38.30%) and 31.70% were illiterate. They were unemployed for 55%. Caregiver burden was absent to mild in 32.20%, mild to moderate in 45.80% and moderate to severe in 22%. Signs of depression were present in 10% of patients, the 30% had a high probability of depression while 60% of patients had no depression. The average length of time the main caregiver was off work was 23.86 days (standard deviation 64.53 days). The average cost of financial losses related to this work stoppage was 200.38 USD (standard deviation 564.72 USD). The average cost of travel was $139.24 (SD $321.03). The average total cost was $339.62 (SD $650.97). The indirect cost of stroke remains quite high and represents a heavy burden for a population where the majority is unemployed, so it is important to propose a psychological support program more adapted to the Senegalese population. The establishment of low-cost home help services and a training program in neuropsychology for clinicians will be useful.

Published in International Journal of Health Economics and Policy (Volume 6, Issue 2)
DOI 10.11648/j.hep.20210602.11
Page(s) 38-43
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Stroke, Depression, Cost, Senegal

References
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[4] Touré K, Sawadogo AA, Sow A, Basse A, Diagne NS, Diop MS, et al. Mortalité des patients hospitalisés pour AVC ischémique en neurologie au CHU de FANN à Dakar. NPG Neurologie-Psychiatrie-Gériatrie. 2017; 17: 230-4.
[5] Aribi L, Baâti I, Damak M, Gaha L, Mhiri C, Amami O. Dépression après un accident vasculaire cérébral chez le sujet âgé: étude transversale à propos de 40 cas. L'information psychiatrique. 2013; 89 (10): 843-50.
[6] Yangatimbi E, Toure K, Ould MLS, Sow A, Diagne NS, Basse A, et al. Epidémiologie de l'AVC ischémique chez des patients âgés à la clinique neurologique du CHU de FANN, Dakar-Sénégal. Journal de neurologie-neurochirurgie-psychiatrie. 2017; 002 (16): 27-34.
[7] Sene D, Basse AM, Ndiaye M, Toure K, Diop MS, Thiam A et al. Prise en charge des accidents vasculaires cérébraux au Sénégal. Rev neurol. 2007; 163: 8-9, 823-7.
[8] Ba A. Accessibilité aux soins hospitaliers des patients victimes d'un accident vasculaire cérébral au Sénégal: à propos de 100 cas vus au service de neurologie du CHNU de FANN-Dakar [Thèse]. Dakar: Université Cheikh Anta Diop; 2007. 174p.
[9] Mpandzou GA, Ngouma A, Ossou-nguiet PM, Nkounkou A, Motoula LDH, Sounga BEP. Evaluation de la charge de l'aidant après un accident vasculaire cérébral au centre hospitalier universitaire de Brazzaville. AJNS – African Journal of Neurological Sciences. 2018; 37 (1).
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[12] Coûts directs et indirects [en ligne]. Lexeco [cité le 13 avril 2019]. Disponible sur: https://lexeco.wordpress.com/c/couts-directs-et-indirects.
[13] Afitap İ, Hatice ŞB, Erkan M, Yasemin Y, Sadiye M, Nilgün M. Economic burden of stroke. Turk J Phys Med Rehab. 2017; 63 (2): 155-9. [DOI: 10.5606/tftrd.2017.183].
[14] Saka Ö, McGuire A, Wolfe C. Cost of stroke in the United Kingdom. Age and Ageing [en ligne]. 2009 [cité le 02 décembre 2019], 38 (1): 27–32. Disponible sur: https://academic.oup.com/ageing/article-abstract/38/1/27/41534.
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    Diop Cheikh Tacko, Gueye Boubacar, Ba Massamba, Coume Mamadou, Ka Ousseynou, et al. (2021). Psychosocial and Economic Evaluation of Stroke Management in the Elderly: A Prospective Study at the Neurology Department in a Hospital in Dakar, Senegal. International Journal of Health Economics and Policy, 6(2), 38-43. https://doi.org/10.11648/j.hep.20210602.11

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    ACS Style

    Diop Cheikh Tacko; Gueye Boubacar; Ba Massamba; Coume Mamadou; Ka Ousseynou, et al. Psychosocial and Economic Evaluation of Stroke Management in the Elderly: A Prospective Study at the Neurology Department in a Hospital in Dakar, Senegal. Int. J. Health Econ. Policy 2021, 6(2), 38-43. doi: 10.11648/j.hep.20210602.11

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    AMA Style

    Diop Cheikh Tacko, Gueye Boubacar, Ba Massamba, Coume Mamadou, Ka Ousseynou, et al. Psychosocial and Economic Evaluation of Stroke Management in the Elderly: A Prospective Study at the Neurology Department in a Hospital in Dakar, Senegal. Int J Health Econ Policy. 2021;6(2):38-43. doi: 10.11648/j.hep.20210602.11

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  • @article{10.11648/j.hep.20210602.11,
      author = {Diop Cheikh Tacko and Gueye Boubacar and Ba Massamba and Coume Mamadou and Ka Ousseynou and Acray Petronille and Faye Adama},
      title = {Psychosocial and Economic Evaluation of Stroke Management in the Elderly: A Prospective Study at the Neurology Department in a Hospital in Dakar, Senegal},
      journal = {International Journal of Health Economics and Policy},
      volume = {6},
      number = {2},
      pages = {38-43},
      doi = {10.11648/j.hep.20210602.11},
      url = {https://doi.org/10.11648/j.hep.20210602.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.hep.20210602.11},
      abstract = {Stroke is the second leading cause of death worldwide and the leading cause of physical disability in the elderly. The objective of the study was to evaluate the psychosocial and economic aspects of its management. We conducted a cross-sectional, descriptive and evaluative study at the neuroscience clinic of FANN National University Hospital from May 8 to August 8, 2019. It involved 60 people aged 60 years and over received in consultation as well as 59 family caregivers who gave their consent. The caregivers' suffering was evaluated using the MINI ZARIT grid consisting of 5 items for a total score ranging from 0 to 7. The psychological impact of the disease was evaluated by the Geriatric Depression Scale in its short version (GDS); composed of 15 items scored from 0 to 1. The direct and indirect financial cost was evaluated on two items: The estimated financial loss associated with the work stoppage estimated by the daily earnings of the primary caregiver. Travel costs related to transportation from home to the neurovascular consultation unit. The mean age of our patients was 71.46 years (standard deviation 7.79 years). Females predominated with a sex ratio of 0.71. Most of our patients were polygamous (38.30%), followed by widowers (35%). Most of the patients had attended Koranic school (38.30%) and 31.70% were illiterate. They were unemployed for 55%. Caregiver burden was absent to mild in 32.20%, mild to moderate in 45.80% and moderate to severe in 22%. Signs of depression were present in 10% of patients, the 30% had a high probability of depression while 60% of patients had no depression. The average length of time the main caregiver was off work was 23.86 days (standard deviation 64.53 days). The average cost of financial losses related to this work stoppage was 200.38 USD (standard deviation 564.72 USD). The average cost of travel was $139.24 (SD $321.03). The average total cost was $339.62 (SD $650.97). The indirect cost of stroke remains quite high and represents a heavy burden for a population where the majority is unemployed, so it is important to propose a psychological support program more adapted to the Senegalese population. The establishment of low-cost home help services and a training program in neuropsychology for clinicians will be useful.},
     year = {2021}
    }
    

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    T1  - Psychosocial and Economic Evaluation of Stroke Management in the Elderly: A Prospective Study at the Neurology Department in a Hospital in Dakar, Senegal
    AU  - Diop Cheikh Tacko
    AU  - Gueye Boubacar
    AU  - Ba Massamba
    AU  - Coume Mamadou
    AU  - Ka Ousseynou
    AU  - Acray Petronille
    AU  - Faye Adama
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    PY  - 2021
    N1  - https://doi.org/10.11648/j.hep.20210602.11
    DO  - 10.11648/j.hep.20210602.11
    T2  - International Journal of Health Economics and Policy
    JF  - International Journal of Health Economics and Policy
    JO  - International Journal of Health Economics and Policy
    SP  - 38
    EP  - 43
    PB  - Science Publishing Group
    SN  - 2578-9309
    UR  - https://doi.org/10.11648/j.hep.20210602.11
    AB  - Stroke is the second leading cause of death worldwide and the leading cause of physical disability in the elderly. The objective of the study was to evaluate the psychosocial and economic aspects of its management. We conducted a cross-sectional, descriptive and evaluative study at the neuroscience clinic of FANN National University Hospital from May 8 to August 8, 2019. It involved 60 people aged 60 years and over received in consultation as well as 59 family caregivers who gave their consent. The caregivers' suffering was evaluated using the MINI ZARIT grid consisting of 5 items for a total score ranging from 0 to 7. The psychological impact of the disease was evaluated by the Geriatric Depression Scale in its short version (GDS); composed of 15 items scored from 0 to 1. The direct and indirect financial cost was evaluated on two items: The estimated financial loss associated with the work stoppage estimated by the daily earnings of the primary caregiver. Travel costs related to transportation from home to the neurovascular consultation unit. The mean age of our patients was 71.46 years (standard deviation 7.79 years). Females predominated with a sex ratio of 0.71. Most of our patients were polygamous (38.30%), followed by widowers (35%). Most of the patients had attended Koranic school (38.30%) and 31.70% were illiterate. They were unemployed for 55%. Caregiver burden was absent to mild in 32.20%, mild to moderate in 45.80% and moderate to severe in 22%. Signs of depression were present in 10% of patients, the 30% had a high probability of depression while 60% of patients had no depression. The average length of time the main caregiver was off work was 23.86 days (standard deviation 64.53 days). The average cost of financial losses related to this work stoppage was 200.38 USD (standard deviation 564.72 USD). The average cost of travel was $139.24 (SD $321.03). The average total cost was $339.62 (SD $650.97). The indirect cost of stroke remains quite high and represents a heavy burden for a population where the majority is unemployed, so it is important to propose a psychological support program more adapted to the Senegalese population. The establishment of low-cost home help services and a training program in neuropsychology for clinicians will be useful.
    VL  - 6
    IS  - 2
    ER  - 

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Author Information
  • Faculty of Community Health, Alioune Dipo University, Bambey, Senegal

  • Faculty of Community Health, Alioune Dipo University, Bambey, Senegal

  • Faculty of Medicine, Pharmacy and Dentistry, Cheikh Anta Dipo University, Dakar, Senegal

  • Faculty of Medicine, Pharmacy and Dentistry, Cheikh Anta Dipo University, Dakar, Senegal

  • Faculty of Community Health, Alioune Dipo University, Bambey, Senegal

  • Faculty of Medicine, Pharmacy and Dentistry, Abidjan University, Ivory Cost

  • Faculty of Medicine, Pharmacy and Dentistry, Cheikh Anta Dipo University, Dakar, Senegal

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