Risk Factors for Hemorrhagic Stroke among Adults in the Democratic Republic of the Congo: A Hospital-Based Study in a Limited Resource Setting

Abstract

Background. The prevalence of stroke is increasing in sub-Saharan Africa. The scarcity of hospital-based stroke data in Lubumbashi (in the Democratic Republic of the Congo) led to the study, which was designed to describe the epidemiology of stroke and identify risk factors associated with hemorrhagic stroke among adult patients in Lubumbashi. Methods. This was a cross-sectional study of 158 adult patients admitted for stroke in the internal medicine department of Lubumbashi University Clinics from January 2018 to December 2020. Sociodemographic and clinical features, cardiovascular risk factors, and hospital mortality were collected. A logistic regression has determined the risk of developing a hemorrhagic stroke. Results. Of 9,919 hospitalized patients, 158 had a stroke with a hospital prevalence of 1.6%; 86 (54.4%) patients had a hemorrhagic stroke while 72 (45.6%) had an ischemic stroke. Of which 41.1% (65/158) were women. The mean age was 60.8 ± 13.3 years. Main clinical signs were hemiplegia (63.3%), headache (48.7%), speech disorders (38.6%), and dizziness (38.6%). Hypertension (82.9%) and hyperglycemia (53.2%) were the most common risk factors. Inhospital mortality was 22.8%. After logistic regression, independent predictors for developing hemorrhagic stroke were hypertension ( aOR = 8.19 ; 95% CI: 2.72–24.66; p < 0.0001 ) and atrial fibrillation ( aOR = 4.89 ; 95% CI: 1.41–16.89; p = 0.012 ). Conclusion. This study highlights the high stroke mortality in a resource-limited hospital and the burden of hypertension in the development of hemorrhagic stroke. It illustrates the need to establish stroke care setting to improve the quality of stroke care.

Stroke signs knowledge and factors associated with a delayed hospital arrival of patients with acute stroke in Kinshasa

“…Hypertension was the participants’ primary modifiable cardiovascular risk factor in the current study. The same has been found in the INTERSTROKE study for African countries included in the study [ 52 ] and in other studies in DRC [ 18 , 19 , 53 ] and elsewhere [ 23 , 24 ]. As the incidence of stroke increases in proportion to blood pressure [ 54 ] and the decrease in stroke mortality over the past decade is attributed, at least in part, to aggressive treatment of hypertension [ 55 ], hypertension is the leading modifiable contributor to stroke, with approximately 52% of all strokes attributable to hypertension [ 56 ].…”

Un miembro del personal de la Building Foundation for Development ayuda a preparar suministros para su entrega a instalaciones sanitarias y campos de desplazados en Al Jazirah (Sudán), que actualmente acoge a desplazados internos que huyen del conflicto en Jartum (Sudán).

“…The prevalence of stroke admissions was 6.8% (95% CI: 4.7–9.6; 17 studies) 41 , 48 , 53 , 55 , 57 , 59 , 70 , 73 , 74 , 81 , 84 – 87 , 91 , 94 , 95 in medical settings, and 5.4% (95% CI: 2.8–10.2; five studies) 54 , 75 , 88 , 93 , 98 in emergency departments. Of these 22 studies, eight used radiological imaging to confirm the diagnosis.…”

“…Of these 22 studies, eight used radiological imaging to confirm the diagnosis. 41 , 54 , 57 , 59 , 74 , 91 , 93 , 98 …”

Meta-Analysis the Effects of Hypertension, High Density Lipoprotein, and Diabetes Mellitus on the Risk of Stroke

“…In line with research that has been conducted to determine the effect of hypertension on the incidence of stroke, including by El-hajj et al, (2019) which shows that people who suffer from hypertension will be at risk 12.5 times compared to those who do not suffer from hypertension. Musung et al, (2022) also said that people who have a history of hypertension will be at risk of having a stroke by 8.1 times higher than those who are not hypertensive.…”