Neurologic illness in Zambia: A neurointensivist's experience

Introduction Management of critically ill patients in dedicated intensive care units (ICUs) is the standard of care in high income countries (HICs), but remains uncommon in low and middle-income countries (LMICs). We sought to determine the prevalence of neurologic disorders in the ICU of a LMIC and examine if resource appropriate specialized neurocritical care training could benefit these patients. Methods From February to March 2017, a trained neurocritical care intensivist recorded encounters in the sole ICU at the University Teaching Hospital (UTH) in Lusaka, Zambia. We stratified each patient by demographics, presence of primary or secondary neurologic deficit, comorbidities, and outcome. Results Of the 33 patients seen during this period, 26 (78.8%) had a neurologic deficit. An equal number of patients carried a primary neurologic diagnosis (13) versus a secondary neurologic diagnosis (13). Primary neurologic disorders included spinal cord injury/tumor/abscess, intracranial hemorrhage, Guillain-Barre syndrome, and traumatic brain injury. Conclusions Over three-quarters of critically ill patients in the observation period carried a neurologic diagnosis. Future research should aim to identify if resource appropriate neurocritical care training of frontline providers may lead to improved clinical outcomes.