Stroke in Africa: profile, progress, prospects and priorities

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.

Accuracy and Validity of a Single Inertial Measurement Unit-Based System to Determine Upper Limb Kinematics for Medically Underserved Populations

“…It has rightfully been suggested that the toll of stroke in LMICs can be reduced by multidisciplinary research and capacity-building, the development and promotion of evidence-based stroke prevention and intervention services, and enhancing stroke awareness among the general population ( Akinyemi et al, 2021 ). Unfortunately, even if such transformations were to begin this year, it would take decades to close the stroke burden gap.…”

Haematological Indices and Antioxidant Enzyme Activity in Ghanaian Stroke Patients

“…Stroke is a cardiovascular disorder causing mortality globally and long-lasting harm worldwide [ 1 , 2 ]. The disease is a leading cause of adult disability [ 3 ], the second cause of dementia [ 4 ], and the third cause of mortality in most developed countries such as sub-Saharan Africa [ 5 ].…”

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“…The establishment of the global Stroke Control, Observatory, and Reduction Ecosystem (gSCORE; appendix p 25 ) 11 , 87 will be key to engage all stakeholders in society to: address key environmental factors via policy change (eg, the social determinants of health and making default choices healthy); enhance stroke awareness through key community influencers who can deliver culturally tailored messages with strategies, such as using social media (ie, social media influencers) and the arts (ie, music, comedy, film, and television); address motivation, self-efficacy, and self-management skills; and empower the stroke commissioners to be the champions and advocates of ensuring rigorous implementation and evaluation across the globe.…”