Challenges of the Management of Stroke in Sub Saharan Africa: Evaluating Awareness, Access and Action

Ekeh, Bertha C.

doi:10.4172/2472-100x.1000128

Cited by 11 publications

(16 citation statements)

References 49 publications

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“…Further, diagnosis is speculative and complex due to lack of imaging modalities. Patients' pre hospital delay precludes the timely initiation of thrombolytic therapy [56].In contrary, low rate of crude mortality was observed in Europe (22%), America (16%), and Asia (16%). Recent advances in system and processes enable developed countries to efficiently use reperfusion therapy.…”

Section: Discussionmentioning

confidence: 99%

Mortality rate and predictors of Stroke: A Meta-Analysis and Systematic Review

Mersha¹,

Abegaz²,

Seid³

et al. 2019

Preprint

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Background Global data on stroke mortality remained to be sparse. In light of this, we aimed to conduct a Meta-analysis and systematic review of observational studies to estimate the mortality of stroke and to identify risk factors that predispose patients for stroke-related death.Methods This study was conducted based on the Meta-Analyses of Observational Studies in Epidemiology (MOOSE) guidelines. Overall mortality, in-hospital and 30- day mortality due to stroke were the primary outcome measures of the study. The meta-analysis was performed using Stata (Version 14, Stata Corp, College Station, Texas). Random-effect models were used for estimating pooled effects.Findings Overall, thirty two studies assessed overall mortality due to stroke. A total number of 2,885, 126 patients were recruited for the study. Pooled estimate indicated that the overall mortality of stroke was reported to be 20% (19%-22%). Whereas, the 30-day and In-hospital mortality were found to be 18% (16%-20%) and 16% (16%-19%), respectively. A subgroup analysis revealed that Africa registered the highest stroke-related death 29% (23%-36%). Hypertension was found to be an important risk factor for mortality secondary to stroke 61.9% (52.8%-71.1%).Conclusion Overall mortality of stroke was estimated to be twenty percent. The burden of stroke mortality was prominent in Africa region. Hypertension remained to be an independent risk factor for stroke mortality. Mortality of stroke can be minimized by establishing stroke centers that promptly deliver emergency management of stroke event.

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Section: Discussionmentioning

confidence: 99%

Mortality rate and predictors of Stroke: A Meta-Analysis and Systematic Review

Mersha¹,

Abegaz²,

Seid³

et al. 2019

Preprint

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“…Furthermore, data obtained from the INTERSTROKE study involving 22 countries indicates that in African countries [47], the gap between those diagnosed with ischemic and hemorrhagic stroke were about 66% and 34%, respectively [29], [47], [48]. In Nigeria and Ghana, the percentage of individuals confirmed to have ischemic stroke was 68% and hemorrhagic stroke 32% whereas in high income countries the percentage was significantly higher for ischemic stroke (91%) and lower for hemorrhagic stroke (9%) [6], [31]. Additionally, when the two subtypes of hemorrhagic strokes were compared, the incidence of intracerebral hemorrhage was higher than subarachnoid hemorrhage [49].…”

Section: Introductionmentioning

confidence: 99%

Non-Modifiable Risk Factors (Age and Sex), Stroke Types, and Outcomes in Rivers State, Nigeria: A Retrospective Hospital-Based Study

Osuegbu¹,

Adeniji²,

Owhonda³

et al. 2021

Preprint

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This study used structural equation modelling (SEM) to evaluate the direct effect of sex and age on stroke types and outcomes in Tertiary Health Facilities in Rives State, Nigeria. The study was a cross-sectional retrospective hospital-based research that utilized specific stroke patients’ information between 2015-2019. The study obtained the sex and age, stroke type (ischemic/hemorrhagic), and outcomes (No disability/disability/death) from the records. The retrieved data was Microsoft Excel (2016), then analyzed using SPSS (version 21, Amos) and STATGRAPHICS centurion (Stat Point Tech., Inc.). From the result, out of the recorded 1916 stroke patients, 1229 (64.1%) were female, while 687 (35.9%) were males. The older adults (>55 years) had more recorded cases (n=1289) than young adults (ages 18–35 years; n=77) and middle-aged adults (ages 36–55 years, n=550). The SEM results showed that age was significantly associated with stroke type (P<0.001) and outcomes (P=0.038), while sex was significantly associated with stroke outcomes (P<0.001). The likelihood of death was 1.3 times higher in hemorrhagic stroke than ischemic stroke. In conclusion, age and sex had direct effects on stroke type, while age had a direct effect on stroke outcome. Hemorrhagic stroke was more likely to cause death than ischemic stroke in the studied population.

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“…In Africa, there is no published information (Chapter 1) to indicate that rehabilitation offered is informed by evidence or that any form of evidence-based guidance is available for stroke rehabilitation. In most African countries, access to acute and/or long-term stroke rehabilitation remains limited because of an insufficient number of rehabilitation workers, scarcity of MDTs, cost of healthcare, lack of access to care, travelling distances, cost of transport, health literacy and cultural beliefs about stroke amongst patients and caregivers Dizon et al 2016a;Ekeh 2017;. The evidence-to-practice gap may be lengthier in LMICs because of contextual and policy barriers to implementation of evidence-based care.…”

Section: Introductionmentioning

confidence: 99%