Stroke Subtypes, Risk Factors and Treatment Outcomes at A Tertiary Hospital Situated in Rural Southwestern Nigeria: A Five- Year Restrospective Observational Study (original) (raw)
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A review of stroke admissions at a tertiary hospital in rural Southwestern Nigeria
Annals of African Medicine, 2011
Background: Stroke is a common neurological disorder and is the third leading cause of death and a major cause of long-term disability. The disease is expected to increase in low-and middle-income countries like Nigeria. There is no information on stroke in rural Nigeria. Objectives: To review the clinical patterns, risk-factors, and outcome of stroke in a tertiary hospital in rural Nigeria and examine the rural-urban variation of stroke hospitalization in Nigeria. Materials and Methods: We carried out a retrospective study of patients who had a clinical diagnosis of stroke at the Federal Medical Centre, Ido-Ekiti, Southwestern Nigeria between November 2006 and October 2009. Results: A total of 101 patients who had stroke were admitted during this review period, accounting for 4.5% of medical admission and 1.3% of total hospital admission. Women accounted 52.5% of cases, with a male to female ratio of 1 : 1.1. Their mean age was 68 ± 12 years. Stroke occurrences increased with age, as almost half (49.5%) of the cases were aged 70 years and majority (84.2%) of them were in low socioeconomic class. The mean hospital stay for stroke treatment was 12 ± 9 days, Glasgow coma score on admission was 11 ± 4. Ischemic stroke was 64.4%; hemorrhagic stroke, 34.7%; and indeterminate, 1.0%. Hypertension (85.2%), diabetes mellitus (23.8%), and tobacco smoking (22.8%) were the common identifi able risk factors for stroke. Of all the patients, 69% had 2 risk factors for stroke. Thirty-day case fatality was 23.8%; it increases with age and was higher among men than women (29.2 vs 18.9%) and in patients with diagnosis of hemorrhagic stroke (34.3 vs 18.5%). The numbers of identifi able risk factors of stroke has no effect on the 30-day case fatality. When compared with stroke in urban areas of Nigeria, we found no differences in frequency of hospitalization (1.3 vs 0.9-4%) and the major risk factor (hypertension). Hemorrhagic stroke was more common in urban than in the rural community (45.2-51 vs 34.7%) and the 30-day case fatality was lower in the rural community (23.8 vs 37.6-41.2%). Conclusion: Stroke is also a common neurological condition in rural Nigeria, in view of the fact that almost 70% of the patients had 2 risk factors of stroke. We recommend that, sustainable, community-friendly intervention programmes are incorporated into the health care system for the early prevention, recognition, and modifi cation of the risk factors in persons prone to the disease.
Journal of Neurosciences in Rural Practice, 2023
Objectives: This research intended to examine the demographic and clinical attributes of stroke admissions in a rural Nigerian hospital. Materials and Methods: A retrospective analysis of stroke admissions was conducted over 1 year. All necessary data were obtained from patients' records and SPSS was employed for data analysis. P < 0.05 was deemed significant. Results: There were 52 stroke cases, accounting for 5.9% of medical admissions. The patients' mean age was 62.81 ± 12.71 years, while females constituted 51.9% of cases. Common risk factors included hypertension (76.9%), hyperlipidemia (38.5%), alcohol (26.9%), and diabetes mellitus (26.9%). Clinical manifestations included hemiparesis/plegia (84.6%), altered consciousness (63.5%), slurred speech (61.5%), cranial nerve deficit (61.5%), aphasia (42.3%), and headache (34.6%). Ischemic stroke (71.2%) predominated over hemorrhagic stroke (28.8%). The average hospitalization duration was 17.62 ± 8.91 days, and the mean onset to arrival time was 121.31 ± 136.06 h. Discharge and mortality rates were 82.7% and 13.5%, respectively. The association between stroke subtypes and mortality was significant (P = 0.001). Conclusion: Stroke constitutes a significant portion of medical admissions in Nigeria, with ischemic stroke being more prevalent. High mortality rates underscore the urgent need to manage risk factors to prevent stroke.
Epidemiology of stroke in a rural community in Southeastern Nigeria
Vascular Health and Risk Management, 2014
The prevalence and incidence of stroke vary from community to community worldwide. Nonetheless, not much is known about the current epidemiology of stroke in rural Nigeria and indeed Africa. Methods: We carried out a two-phase door-to-door survey in a rural, predominantly low-income, community in Anambra, Southeastern Nigeria. We used a modified World Health Organization (WHO) protocol for detecting neurological diseases in the first phase, and a stroke-specific questionnaire and neurological examination in the second phase. An equal number of sex-and age-matched stroke-negative subjects were examined. Results: We identified ten stroke subjects in the study. The crude prevalence of stroke in rural Nigeria was 1.63 (95% confidence interval [CI] 0.78-3.00) per 1,000 population. The crude prevalence of stroke in males was 1.99 (95% CI 0.73-4.33) per 1,000, while that for females was 1.28 (95% CI 0.35-3.28) per 1,000 population. The peak age-specific prevalence of stroke was 12.08 (95% CI 3.92-28.19) per 1,000, while after adjustment to WHO world population, the peak was 1.0 (95% CI 0.33-2.33) per 1,000. Conclusion: The prevalence of stroke was found to be higher than previously documented in rural Nigeria, with a slightly higher prevalence in males than females. This is, however, comparable to data from rural Africa.
Journal of Stroke and Cerebrovascular Diseases, 2014
is experiencing an epidemiologic transition with stroke contributing to the disease burden. However, community-based stroke prevalence studies are sparse. This study aimed to determine the prevalence of stroke in a rural population in the Niger Delta region in south-south Nigeria and to describe known risk factors for stroke among them. A door-to-door stroke prevalence study was conducted in 2008 among randomly selected adults of 18 years or older in rural Kegbara-Dere community in Rivers State, south-south Nigeria. We administered a modified screening tool by the World Health Organization, a stroke-specific questionnaire, and conducted a physical/neurological examination (on persons screening positive) in 3 stages of assessments. The crude prevalence of stroke was 8.51/ 1000 (95% confidence interval [CI] 5 3.9-16.1) representing 9 of 1057 participants. The age-adjusted prevalence was 12.3/1000 using the US Population 2000. Men had higher unadjusted prevalence than women (12.9/1000 versus 5.1/1000) but were not at more risk (unadjusted relative risk 5 .99; 95% CI 5 .98-1.00). Stroke prevalence increased with age (Mantel-Haenszel c 2 P 5 .00). Hypertension (blood pressure $140/90 mm Hg) was present in all stroke cases and diabetes mellitus (fasting blood sugar .126 mg/dL) in 1 person, but none had hypercholesterolemia, obesity (body mass index .30 kg/m 2), or a history of alcohol intake or smoking. Stroke prevalence was found to be high, commoner among men and the elderly population, and likely to be predisposed by hypertension, in rural south-south Nigeria. The need to conduct follow-up studies on the burden and outcomes of stroke among this study population is acknowledged.
Dutse Journal of Pure and Applied Sciences
Stroke is a cerebrovascular disease that disturbs or damages the blood supply to the brain. This study aimed to evaluate the demographic and clinical characteristics of stroke cases in Murtala Muhammed Specialist Hospital, Kano, Nigeria. Five years of records of three hundred (300) stroke patients comprised of biodata and clinical data were collected. The data were expressed as mean±SD, while simple percentage and Chi-square (χ2) tests were used to determine the incidence and association between the variables respectively using Minitab 17.0 software. The results showed an incidence of 182 (61%) males and 118 (39%) females, 265 (78%) and 65 (22%) for the above and below 40 years age groups respectively. The Hausa, Yoruba and Igbo ethnic groups have an incidence of 258 (86%), 24 (8%), and 18 (6%) respectively. The yearly incidence was 40 (13%), 50 (17%), 20 (7%), 56 (17%), and 134 (45%) for 2017 through 2021, respectively. The incidence of hemorrhagic, ischaemic, and transient i...
Stroke in Developing Countries, Experience at Kano, Northwestern Nigeria
Objectives: As no report on the clinical pattern of stroke in Kano is available, we sought to determine the stroke types, the risk factors associated with stroke, reasons for delay presentation, management issues and outcome of stroke in Kano, Northwestern Nigeria. Methods: In this prospective study, consecutive patients that were admitted to the medical wards of the two tertiary hospitals; Aminu Kano Teaching Hospital (AKTH), Kano and Murtala Muhammad Specialist Hospital, (MMSH) Kano, from June 2008 to June 2010 were recruited in the study. Diagnosis of stroke and its type were determined by clinical and neuroimaging techniques. Risk factor analysis was made based on clinical, laboratory and other relevant investigational data. The case fatality at 24 hours and 7 days were recorded. The survivors were followed in neurology clinics for 6 months; status of disability on admission and at discharge was recorded using modified Rankin disability scale. Results: Over a period of 3 years, a total of 273 comprising 179 males and 94 females (m: f = 2:1) stroke patients were recruited. Their age ranged between 18 and 90 with a mean age of 55 yrs (sd-16.5) but the mean age was 52 (s.d =17.6) in males and 60 (s.d= 11.5) in females. The peak age was in the seventh decade. One hundred and seventy four (63.7%) had infarctive stroke while ninety nine (36.3%) had haemorhagic stroke (91 intracerebral and 8 subarachnoid haemorhage). Reasons for the delay included delay referral from private hospital (49.1%), visit to traditional homes before coming to hospital (10.6%), treatment at home (7%), transportation problem (32.2%) and others (1.1%). Overall one hundred and seventy one (63%) survived and one hundred and two (37%) died. The case fatality for stroke was 10% in the first 24 hours and 22% at 7 days. Conclusion: The clinical pattern and outcome of stroke found in this study are similar to that reported in other geopolitical zones of Nigeria and other developing countries.
Stroke Risk Factors, Subtypes, and 30-Day Case Fatality in Abuja, Nigeria (P1.121)
Neurology, 2014
acute stroke care, the extent of laboratory investigations, and the prediction of likely outcomes. Unfortunately, most studies on stroke in Nigeria involve little or no imaging protocols, 3-8 largely because most health centers lack facilities for computerized tomography (CT) scanning, magnetic resonance imaging (MRI), and carotid Doppler ultrasound scanning. Often, where those facilities are available, they are unaffordable. 4,7 In two studies from Southwest Nigeria, 4,6 only 2 of 101 and none of 708 patients with suspected stroke had brain CT scans. In other studies from Northwest 7 and central 8 Nigeria, brain scans were obtained in only 6 of 81 and none of 76 patients. One study 9 did not describe imaging findings altogether, and it is unclear whether patients had had brain scans. Owing to these limitations, most studies rely on World Health Organization (WHO) criteria and
Stroke risk factors, subtypes, and 30-day case fatality in Abuja, Nigeria
Nigerian Medical Journal, 2013
acute stroke care, the extent of laboratory investigations, and the prediction of likely outcomes. Unfortunately, most studies on stroke in Nigeria involve little or no imaging protocols, 3-8 largely because most health centers lack facilities for computerized tomography (CT) scanning, magnetic resonance imaging (MRI), and carotid Doppler ultrasound scanning. Often, where those facilities are available, they are unaffordable. 4,7 In two studies from Southwest Nigeria, 4,6 only 2 of 101 and none of 708 patients with suspected stroke had brain CT scans. In other studies from Northwest 7 and central 8 Nigeria, brain scans were obtained in only 6 of 81 and none of 76 patients. One study 9 did not describe imaging findings altogether, and it is unclear whether patients had had brain scans. Owing to these limitations, most studies rely on World Health Organization (WHO) criteria and
Universal Journal of Public Health, 2023
Introduction: Cardiovascular diseases, particularly strokes are a public health issue in Niger, a lower middle-income country. The study aimed to identify the risk factors associated with the occurrence of stroke at Niamey's national and general referral hospitals. Method: A cross-sectional study was carried out in the Niamey referral hospitals over the period January 1st, 2019 to December 31, 2021. A multivariate logistic regression model was used to identify potential predictors of stroke. Results: A total of 2,352 patients were included in the study, of whom 1,034 were diagnosed with stroke. The mean age of the patients was 59±15 years. The M/F sex ratio was 1.18. Factors associated with the occurrence of stroke were: elder age (p=0.038), female (p=0.001), unemployed (p<0.0001), lowest monthly-income (p<0.0001), family history of stroke (p=0.003), high blood pressure (p<0.0001), diabetes (p<0.0001), obesity (p=0.001), smoking (p=0.002), and hypercholesterolemia (p<0.0001). Conclusion: Socio-demographics characteristics, family history, high blood pressure, diabetes, obesity, smoking, and hypercholesterolemia increased the occurrence of stroke in Niger. It is necessary to raise public awareness of the potential predictors of stroke and to improve the technical platform for patient management.
Stroke is a common neurologic disorder and it is the third leading cause of mortality worldwide after ischaemic heart disease and cancer. Males are predominantly affected and ischaemic stroke is more prevalent than haemorrhagic stroke. This study determined the pattern and presentation of stroke in Federal Teaching Hospital Abakaliki (FETHA) South-East Nigeria. It was a retrospective, descriptive and hospital based study. The stroke register of the neurology unit was reviewed and relevant data were extracted and analyzed using Statistical Package for Social Sciences (SPSS) version 19 software. The sex ratio was M:F =3:2 and the peak age prevalence of stroke was the 7 th decade. Ischaemic stroke was present in 65%, while intracerebral haemorrhage and subarachnoid haemorrhage were 31% and 4% respectively. Stroke constituted 12% of medical deaths with 30 day case mortality rate of 15%. Stroke is highly prevalent in Abakaliki south east Nigeria. The 30 day case mortality rate is relatively low in this study. There should be regular public enlightenment for stroke prevention and prompt referral of stroke patients to a stroke unit for adequate management.