Childhood arterial ischemic stroke in Senegal (West Africa)

Ndiaye, Moustapha; Lengue, F.; Sagna, Salimata Diang; Sow, Ahmadou Bamba; Fogany, Yannick; Deme, Hamidou; Basse, Anna Modji; Diop, Marième Soda; Diagne, N.S.; Diop, Amadou Gallo; Ndiaye, Ousmane

doi:10.1016/j.arcped.2018.06.007

Cited by 10 publications

(7 citation statements)

References 16 publications

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“…Indeed only 4% of the patients had died with the mean follow-up of 26.9 months, but 28% were lost to follow-up. 22 It should be borne in mind that the diagnosis of stroke in children is hard due to the lack of specialists (neuropediatricians) in SSA. The one-month case-fatality rate (CFR) ranged from 1.1% to 83.3% with the pooled estimated stroke mortality of 24.14% with high heterogeneity.…”

Section: Discussionmentioning

confidence: 99%

Stroke case fatality in sub-Saharan Africa: Systematic review and meta-analysis

Adoukonou

Kossi

Mefo

et al. 2021

International Journal of Stroke

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Background: The burden of stroke is high in sub-Saharan Africa (SSA), but few data are available on its long-term mortality. Objective: To estimate over one-month stroke case-fatality in sub-Saharan Africa Methods: Systematic review and meta-analysis was performed according to Meta-analysis of Observational Studies in Epidemiology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO protocol: CRD42020192439), on five electronic databases (PubMed, Science direct, AJOL, EMBASE and Web of Sciences). We searched all studies on stroke mortality case-fatality over one-month in SSA published between 1st January 2000 and 31 December 2019. Results: We included 91 studies with 34,362 stroke cases. The one-month pooled stroke case-fatality rate was 24.1% [95%CI: 21.5-27.0] and 33.2% [95%CI: 23.6-44.5] at 1-year. At 3 and 5-years the case-fatality rates were respectively 40.1% [95% CI: 20.8-63.0] and 39.4% [95%CI: 14.3-71.5] with high heterogeneity. Hemorrhagic stroke was associated with a higher risk of mortality at one month, but ischemic stroke increased the risk of mortality over 6 months. Diabetes was associated with poor prognosis at 6 and 12 months with odds ratios of 1.64 [95% CI: 1.22-2.20] and 1.85 [1.25-2.75] respectively. Conclusion: The stroke case-fatality over one-month was very high compared to other reported in Western countries and can be explained by the weak healthcare systems and vascular risk factors despite the high heterogeneity in this review.

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Section: Discussionmentioning

confidence: 99%

Stroke case fatality in sub-Saharan Africa: Systematic review and meta-analysis

Adoukonou

Kossi

Mefo

et al. 2021

International Journal of Stroke

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“…The authors observed, among others, pharyngitis, meningitis, otitis media, or history of chicken pox in the last 12 months prior to stroke. In turn, in children with AIS from Senegal, 3 patients had meningitis, which was assigned to Cryptococcus neoformans (1 case) and Mycobacterium tuberculosis (2 cases), which then revealed a stroke [ 28 ]. The general effects of infection lead to temporary thrombophilia, and hypercoagulable states are considered a risk factor for AIS in younger patients [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Analysis of 622 paediatric hospitalisations due to arterial ischaemic stroke in Poland – National Health Fund registry-based study from 2011 to 2020

et al. 2022

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IntroductionThe present study aimed to evaluate the prevalence of the arterial ischaemic stroke (AIS) in Polish children, as well as to analyse the parameters related to AIS hospitalization, including age, gender, region, month and season of a year at admission, duration and costs based on data from National Health Fund (NHF) registery in 2011–2020.Material and methodsData from the NHF were analysed statistically. The disease was identified according to the codes I63 and I64 of the International Classification of Diseases, Tenth Revision (ICD-10), and patients included only individuals up to 18 years of age. Results We identified 622 hospitalisations due to paediatric AIS in Poland in the study period.ResultsThe most frequent age subgroups were adolescents, followed by toddlers or pre-school children (34.73% and 24.12%, respectively), while the least frequent – neonates or infants (9.81%). ICD-10 procedures did significantly affect the duration and costs of hospitalisation (p<0.001). The highest costs of hospitalisations concerned the I63.1 procedure (cerebral infarction due to embolism of precerebral arteries), which included thrombectomy. Duration and costs of hospitalisation were positively correlated to each other (r=0.525, p<0.001). Age correlated negatively with duration of hospitalisation (r= -0.154, p<0.001) and positively with costs of hospitalisation (r =0.133, p=0.008).ConclusionsData from the NHF registry proved that AIS occurs more often in boys than girls and is more common in adolescents (15–18 years) than younger children.

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“…Similarly, in the 2018 National Demographic Health Survey in Nigeria, which included testing for SCD, 10% of the children aged 6 months to 5 years who were found to have severe anemia were also shown to have SCA [22]. Finally, in an 11-year chart review of stroke cases at Senegal's only pediatric hospital, children with SCD, the majority of them undiagnosed with mean onset age of 6 years, accounted for 38% of all cases [23]. Senegal's estimated SCD birth prevalence is 0.5-0.6% [1].…”

Section: Main Discussionmentioning

confidence: 99%

Caring for Africa’s sickle cell children: will we rise to the challenge?

Oron

Chao

Ezeanolue

et al. 2020

BMC Med

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Background Most of the world’s sickle cell disease (SCD) burden is in Africa, where it is a major contributor to child morbidity and mortality. Despite the low cost of many preventive SCD interventions, insufficient resources have been allocated, and progress in alleviating the SCD burden has lagged behind other public-health efforts in Africa. The recent announcement of massive new funding for research into curative SCD therapies is encouraging in the long term, but over the next few decades, it is unlikely to help Africa’s SCD children substantially. Main discussion A major barrier to progress has been the absence of large-scale early-life screening. Most SCD deaths in Africa probably occur before cases are even diagnosed. In the last few years, novel inexpensive SCD point-of-care test kits have become widely available and have been deployed successfully in African field settings. These kits could potentially enable universal early SCD screening. Other recent developments are the expansion of the pneumococcal conjugate vaccine towards near-universal coverage, and the demonstrated safety, efficacy, and increasing availability and affordability of hydroxyurea across the continent. Most elements of standard healthcare for SCD children that are already proven to work in the West, could and should now be implemented at scale in Africa. National and continental SCD research and care networks in Africa have also made substantial progress, assembling care guidelines and enabling the deployment and scale-up of SCD public-health systems. Substantial logistical, cultural, and awareness barriers remain, but with sufficient financial and political will, similar barriers have already been overcome in efforts to control other diseases in Africa. Conclusion and recommendations Despite remaining challenges, several high-SCD-burden African countries have the political will and infrastructure for the rapid implementation and scale-up of comprehensive SCD childcare programs. A globally funded effort starting with these countries and expanding elsewhere in Africa and to other high-burden countries, including India, could transform the lives of SCD children worldwide and help countries to attain their Sustainable Development Goals. This endeavor would also require ongoing research focused on the unique needs and challenges of SCD patients, and children in particular, in regions of high prevalence.

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Childhood arterial ischemic stroke in Senegal (West Africa)

Cited by 10 publications

References 16 publications

Stroke case fatality in sub-Saharan Africa: Systematic review and meta-analysis

Stroke case fatality in sub-Saharan Africa: Systematic review and meta-analysis

Analysis of 622 paediatric hospitalisations due to arterial ischaemic stroke in Poland – National Health Fund registry-based study from 2011 to 2020

Caring for Africa’s sickle cell children: will we rise to the challenge?

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