Stroke in South West Nigeria

Abstract

Background and Purpose-Stroke is a significant economic, social, and medical problem worldwide. This retrospective follow-up study aimed to review the pattern, types, and case fatality of stroke in Nigeria. Methods-Records of all stroke patients admitted into Ogun State University Teaching Hospital (OSUTH), Sagamu, from December 1993 to November 2003 were reviewed. Patients were classified into hemorrhage or infarct using the World Health Organization criteria. Information was obtained as to the time of death in those who died and case fatality at 24 hours, 7 days, 30 days, and 6 months recorded. Autopsy records were also reviewed. Results-A total of 708 stroke patients were reviewed and this constituted 2.4% of all emergency admissions. On clinical grounds, 49% of the patients had cerebral infarction (CI) and 45% had intracerebral hemorrhage (ICH), whereas 6% had subarachnoid hemorrhage. Stroke constituted 1.8% of all deaths at the emergency unit and the case fatality was 9% at 24 hours, 28% at 7 days, 40% at 30 days, and 46% at 6 months. Conclusion-Stroke constitutes a significant cause of mortality and the need for prompt institution of intensive treatment is emphasized. A changing pattern with an increasing frequency of hemorrhagic stroke in our population is suspected. However, because this was a retrospective study based on clinical examination in a highly selected stroke population, neuroimaging confirmation would be needed for any future prospective hospital or population-based studies.

Blood pressure, prevalence of hypertension and hypertension related complications in Nigerian Africans: A review

“…Available hospital based studies in Nigeria suggest there are rising rates of stroke in the country [154] . Available data, at least from hospital based studies, show that stroke accounts for 0.23%-4.0% of all hospital admissions, 0.5%-45% neurological admissions and 5%-17% of deaths on medical wards.…”

“…It is the commonest cause of neurological admission in Lagos, the largest city and the commercial nerve centre of Nigeria. Cerebral infarction, intracerebral hemorrhage and subarachnoid haemorrhage, respectively, are responsible for 64%, 19% and 6% of strokes in the country [154] . In a community based study in Lagos [155] , stroke prevalence was estimated as 1.14 per 1000 (1.51/1000 in men, 0.69/1000 in women and 24.1/1000 in those older than 65 years.…”

“…The mortality associated with stroke in Nigeria is high with 30 d case fatality ranging from 28% to 40% [154] . In a 10-year review of stroke in Sagamu, Ogun State, stroke accounted for 2.4% of all emergency admissions.…”

Pattern of Annual Distribution and Prevalence of Type 2 Diabetes Mellitus amongst Adult Patients at Government House Clinic, Umuahia, Abia State, Nigeria: Ten Years in Retrospect

“…In their seperate studies, Ogun (2005) 27 and Umuerri (2013), 28 found that Cardiovascular complications of DM such as stroke, and peripheral disease occured in 11% and 37% respectively of persons with DM respectively in hospital settings in Nigeria. However, 2.1% of cases of heart failure is noted to be due to DM.…”

Sickle Cell Trait Appears to Increase the Risk of Hemorrhagic Stroke in African Adults with Dyslipidaemia: A Pilot Study

“…Some studies have found haemorrhagic stroke to be commoner in adults with sickle cell disease as a result of the development of moyamoya disease [33,34] which results from the formation of poorly endothelialised vessels following vascular occlusion. In most studies on the pattern of stroke in Nigeria, ischaemic stroke has always been the more common [35][36][37][38] except in a few cases in urban centres [39] in one of which Ogun, et al used the WHO criteria to classify the stroke types. The significant difference between the two groups in this study in terms of the pathologic stroke types is likely to be due to the presence of sickle cell trait in line with the observation of Ajayi, et al [4] in their study that the risk of haemorrhagic stroke was 10 times that of ischaemic stroke in sickle cell patients.…”