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Publications

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Review Ppublish 203 citations

PubMed: 34526674 DOI: 10.1038/s41582-021-00542-4

Stroke in Africa: profile, progress, prospects and priorities.

Nat Rev Neurol 17(10):634-656

Authors: Rufus O Akinyemi, Bruce Ovbiagele, Olaleye A Adeniji, Fred S Sarfo, Foad Abd-Allah, Thierry Adoukonou, Okechukwu S Ogah, Pamela Naidoo, Albertino Damasceno, Richard W Walker, Adesola Ogunniyi, Rajesh N Kalaria, Mayowa O Owolabi

Affiliations

  • Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria.
  • Centre for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria.
  • Department of Neurology, University College Hospital, Ibadan, Nigeria.
  • Neurovascular Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle, UK.
  • Department of Neurology, University College Hospital, Ibadan, Nigeria.
  • Department of Neurology, University of California, San Francisco, CA, USA.
  • Kwame Nkrumah University of Science & Technology, Kumasi, Ghana.
  • Komfo Anokye Teaching Hospital, Kumasi, Ghana.
  • Department of Medicine, Federal Medical Centre Abeokuta, Ibadan, Nigeria.
  • Department of Neurology, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt.
  • Department of Neurology, University Teaching Hospital, Parakou, Benin.
  • Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria.
  • Department of Medicine, University College Hospital/College of Medicine, University of Ibadan, Ibadan, Nigeria.
  • Heart and Stroke Foundation South Africa/University of the Western Cape, Cape Town, South Africa.
  • Department of Cardiology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
  • Department of Medicine, North Tyneside General Hospital, Tyne and Wear, UK.
  • Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
  • Neurovascular Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle, UK.
  • Centre for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria.

Abstract

Stroke is a leading cause of disability, dementia and death worldwide. Approximately 70% of deaths from stroke and 87% of stroke-related disability occur in low-income and middle-income countries. At the turn of the century, the most common diseases in Africa were communicable diseases, whereas non-communicable diseases, including stroke, were considered rare, particularly in sub-Saharan Africa. However, evidence indicates that, today, Africa could have up to 2-3-fold greater rates of stroke incidence and higher stroke prevalence than western Europe and the USA. In Africa, data published within the past decade show that stroke has an annual incidence rate of up to 316 per 100,000, a prevalence of up to 1,460 per 100,000 and a 3-year fatality rate greater than 80%. Moreover, many Africans have a stroke within the fourth to sixth decades of life, with serious implications for the individual, their family and society. This age profile is particularly important as strokes in younger people tend to result in a greater loss of self-worth and socioeconomic productivity than in older individuals. Emerging insights from research into stroke epidemiology, genetics, prevention, care and outcomes offer great prospects for tackling the growing burden of stroke on the continent. In this article, we review the unique profile of stroke in Africa and summarize current knowledge on stroke epidemiology, genetics, prevention, acute care, rehabilitation, outcomes, cost of care and awareness. We also discuss knowledge gaps, emerging priorities and future directions of stroke medicine for the more than 1 billion people who live in Africa.

MeSH

Stroke, Incidence, Epidemiology, Genetics, Communicable Diseases, Income, Nervous System Diseases, Prevalence, Noncommunicable Diseases

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