Frequency of recurrent stroke in Burkina Faso: an observational hospital based study of 6 months

Abstract

Introduction studies on stroke recurrence are rare in sub-Sahara Africa. The aim to this study is to determine the prevalence and risk factors for recurrent stroke in two University Teaching Hospital in Burkina Faso. Methods this prospective cross-sectional study was carried on 266 stroke patients admitted in two hospitals in the city of Ouagadougou from September 1, 2017 to February 28, 2018. Patients with stroke recurrence (ischemic or hemorrhagic) were included. Results of 266 acute stroke patients included, 44 (16.4%) had recurrent stroke. The mean age of patients was 66.5 ± 11.49 years with male predominance. Hypertension was the most vascular risk factors (81.8%). Previous stroke was ischemic in 61.4%, hemorrhagic in 22.7% and unknown in 15.9% of cases. Poor compliance (< 60%) was determined in patients taking antiagregant (43.6%) and statins (50%). At admission, the most neurological disorders was motor deficit (100%), aphasia (84.1%), and deglutition disorders (15.9%). CT scan showed ischemic in 82% and hemorrhagic stroke in 18% of cases. With the analysis of second stroke, recurrent stroke after intracerebral hemorrhage was hemorrhagic in 77.8% and ischemic in 22.2%. Recurrent stroke after ischemic stroke was ischemic in 100%. Conclusion stroke recurrence is common in our context. Hypertension was the most common vascular risk factor in recurrent stroke. Poor compliance was determined in patients taking antiagregant agents and statins in previous stroke.

Stroke Recurrence Rate and Risk Factors Among Stroke Survivors in Sub-Saharan Africa: A Systematic Review

“…The adapted Newcastle–Ottawa Scale (NOS) ratings for three studies ranged from a low of 6 to a high of 8. One study had a sample size of only 100, 27 two studies had between 200 and 300 study participants, 18 , 24 and the rest had more than 500 study participants. 25 , 28 …”

“… 27–29 In a study from Burkina Faso by Dabilgou et al, forty-four patients were hospitalized due to recurrent stroke of which 13.9% were admitted for a second stroke, while 2.6% were admitted for a third stroke. 24 While in Ghana and Nigeria, 9.4% had recurrent strokes, 25 and in a community study in Tanzania, 1.99% had stroke recurrence. 18 …”

“…The mean interval between the index and second stroke was 24±24.34 months (3 months – 10 years); 1–2 years in 37.8%, >3 years in 28.4% and 14.9% within six months; 16.0 months (95% CI = 3.36–28.64). 24 Most of the patients had their strokes after 12 months. 24 …”

“…Diabetes mellitus was associated with recurrent strokes in two studies, 25 , 28 while three studies reported that diabetes mellitus was not associated with stroke recurrence. 24 , 27 , 29 Though one study noted that casual blood glucose was statistically associated with recurrence. 27 …”

“…Mbonda et al reported a 23% death rate among those with stroke recurrence; 29 other studies did not report mortality rates. 18 , 24 , 27 …”