Background and Purpose:Intracerebral hemorrhage (ICH) constitutes now 52% of all strokes. Despite of its deadly pattern, locally there is no clinical grading scale for ICH-related mortality prediction. The first objective of this study was to develop a risk stratification scale (Kinshasa ICH score) by assessing the strength of independent predictors and their association with in-hospital 30-day mortality. The second objective of the study was to create a specific local and African model for ICH prognosis.Materials and Methods:Age, sex, hypertension, type 2 diabetes mellitus (T2DM), smoking, alcohol intake, and neuroimaging data from CT scan (ICH volume, Midline shift) of patients admitted with primary ICH and follow-upped in 33 hospitals of Kinshasa, DR Congo, from 2005 to 2008, were analyzed using logistic regression models.Results:A total of 185 adults and known hypertensive patients (140 men and 45 women) were examined. 30-day mortality rate was 35% (n=65). ICH volume>25 mL (OR=8 95% CI: 3.1-20.2; P<0.0001), presence of coma (OR=6.8 95% CI 2.6-17.4; P<0.0001) and left hemispheric site of ICH (OR 2.6 95% CI: 1.1-6; P=0.027) were identified as significant and independent predictors of 30-day mortality. Midline shift > 7 mm, a consequence of ICH volume, was also a significant predictor of mortality. The Kinshasa ICH score was the sum of individual points assigned as follows: Presence of coma coded 2 (2 × 2 = 4), absence of coma coded 1 (1 × 2 = 2), ICH volume>25 mL coded 2 (2 × 2=4), ICH volume of ≤25 mL coded 1(1 × 2=2), left hemispheric site of ICH coded 2 (2 × 1=2), and right hemispheric site of hemorrhage coded 1(1 × 1 = 1). All patients with Kinshasa ICH score ≤7 survived and the patients with a score >7 died. In considering sex influence (Model 3), points were allowed as follows: Presence of coma (2 × 3 = 6), absence of coma (1 × 3 = 3), men (2 × 2 = 4), women (1 × 2 = 2), midline shift ≤7 mm (1 × 3 = 3), and midline shift >7 mm (2 × 3 = 6). Patients who died had the Kinshasa ICH score ≥16.Conclusion:In this study, the Kinshasa ICH score seems to be an accurate method for distinguishing those ICH patients who need continuous and special management. It needs to be validated among large African hypertensive populations with a high rate of 30-day in–hospital mortality.

Background and Purpose. It now appears clear that both HIV/AIDS and antiretroviral therapy (HAART) use are associated with higher risk of cardiovascular disease such as stroke. In this study, we evaluated the prevalence, the risk factors, and the cardiometabolic comorbidities of stroke in HIV/AIDS Central African patients. Methods. This hospital-based cross-sectional study collected clinical, laboratory, and imaging data of black Central African heterosexual, intravenous drug nonuser, and HIV/AIDS patients. Results. There were 54 men and 62 women, with a female to male ratio of 1.2 : 1. All were defined by hypercoagulability and oxidative stress. Hemorrhagic stroke was reported in 1 patient, ischemic stroke in 17 patients, and all stroke subtypes in 18 patients (15%). Younger age <45 years (P = .003), autoimmunity (P < .0001), and metabolic syndrome defined by IDF criteria (P < .0001) were associated with ischemic stroke. Conclusions. Clustering of several cardiometabolic factors, autoimmunity, oxidative stress, and lifestyle changes may explain accelerated atherosclerosis and high risk of stroke in these young black Africans with HIV/AIDS. Prevention and intervention programs are needed.

Background and Purpose: Ischemic stroke causes death and disability worldwide. Better understanding and controlling factors associated will improve the prevention of the disease. This study reviews records of patients with ischemic stroke in Central Africa. Material and methods: Patients of Bantu ethnicity with clinical diagnosis of stroke and lesion on computed tomography scan from January 2011 to December 2012 were selected. Computed tomographic subtypes of ischemic stroke and factors associated were considered with tropical seasonal variation. Results: Of the 303 first-ever stroke patients (average age 53 years old, range 3-84 years old; 62% male) were included in the study. The prevalence of computed tomography stroke subtypes was: lacunar infarct (63%) and non lacunar infarct lesion (37%). Silent brain infarct was seen in 9 % of patients. Prevalence of factors associated with ischemic stroke was: age≥60 years old (55%); male gender (63%), chronic and uncontrolled hypertension (54%) and type 2 Diabetes mellitus (11%). A seasonal high prevalence was observed in warmer season (p < 0.05). Conclusions: This study shows a high prevalence of lacunar infarct than non lacunar in Bantu of Central Africa.

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This study seemed to determine the pattern and features of vertebral fractures in black African women which may be useful for comparisons with the pattern of worldwide populations.

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Background:Sickle cell anemia is the most common genetic disease in sub-Saharan Africa. It is an inherited autosomal recessive disorder characterized by chronic hemolysis secondary to falciformation of red blood cells, also responsible of ischemia, bone infarction and accompanied by serious infections and organic lesions.Normal for weight at birth, Sickle cell anemia subjects have low pre puberty growth compared to normal children and also have compromised bone remodeling balance which results in decrease of bone mass and increase of bone fragility. Several studies have established that 37% to 50% of SCA patients were osteopenic or osteoporotic. This study aims to confirm the existence of bone remodeling disorders with osteoporotic translation and to compare the values found in Congolese sickle cell adults subjects to the general population.Methods: Spine and hip DXA were conducted on 270 SS homozygotes aged 18 to 50 years (121 men and 149 women) and 359 AA homozygotes as controls (138 men and 221 women), aged from 18 to 50 years old, who agreed to participate in the study, considered as a control group. AS heterozygotes were not included in the study. Results: AA subjects shows higher density (BMD) and Bone mineral content (BMC) values. Both SCAand AA controls showed the characteristic curve with peak bone mass at the fourth decade of life, followed by a decay with age. The difference in BMD and BMC with the control population ranged from 7.94% to 26.34% (average of 16.02%) which whereas, equivalent of -0.9 to -2 standard deviations.The overall decrease in bone mass rate for -2.5 DS of the T-score was: -28.4% and 33.2% for -2 DS of T-score.Conclusion: SCA subjects shows high rate of osteopenia and osteoporosis and are more likely at risk for fractures.