Etiologies of Ischemic Stroke in Sub-Saharan Africa, Case of Benin
- 1 Department of Neurology, Teaching Hospital, Parakou, Bénin
- 2 Department of Neurology, Teaching Hospital, Cotonou, Bénin
- 3 Department of Neurology, Teaching Hospital, Cotonou, Bénin
- 4 Department of Neurology, Teaching Hospital, Cotonou, Bénin
- 5 Department of Neurology, Teaching Hospital, Cotonou, Bénin
- 6 Department of Neurology, Teaching Hospital, Cotonou, Bénin
Abstract
The purpose of our study was to investigate etiologies of ischemic stroke in the neurology university clinic of CNHU-HKM, Cotonou. Method: It was a cross-sectional, prospective and analytical study carried out from 1 <sup>st</sup> November 2014 to 31 <sup>st</sup> August 2015 in the neurology university clinic of CNHU-HKM. We included all patients with stroke whose ischemic nature was confirmed through brain CT scan or magnetic resonance imaging. Data analysis was conducted with Census and Survey Processing System (CSPRO). We carried out bivariate then multivariate analysis in identifying associated factors. Threshold value is estimated at p < 0.05. Results: 104 ischemic stroke patients participated in the study, representing 59.4% of all types of stroke. Mean age was 61.9 ± 12.3 years [26 - 87 years] with 1.6 as sex ratio. Among vascular risk factors, hypertension accounted for 85.6% of stroke cases. 29.8% suffered from aphasia. Embolic heart diseases and atherosclerosis were predominant, in a proportion of 53% and 26% respectively. Atrial Fibrillation (AF) accounted for 82% of embolic heart diseases. Conclusion: Etiologic investigation of stroke is important and should be systematically carried out. This study enabled to corroborate atherosclerosis predominance in etiologic investigation of ischemic stroke. Patients’ outcome could be improved by promptly managing the etiology through adoption of appropriate treatment.
- Feigin, V.L., Mensah, G.A., Norrving, B., Murray, C.J.L., Roth, G.A., Bahit, M.C., et al. (2015) Atlas of the Global Burden of Stroke (1990-2013): The GBD 2013 Study. Neuroepidemiology, 45, 230-236. https://doi.org/10.1159/000441106
- Feigin, V.L., Norrving, B. and Mensah, G.A. (2017) Global Burden of Stroke. Circulation Research, 120, 439-448. https://doi.org/10.1161/CIRCRESAHA.116.308413
- Gnonlonfoun, D., Adjien, C., Ossou-Nguiet, P., Mapoure, Y., Houinato, D. and Avode, D. (2013) La fréquence hospitalière des affections neurologiques au CNHU-HKM de Cotonou. Journal de la Société de Biologie Clinique, 18, 43-48.
- Balogou, A.A.K., Tossa, K.R., Kowu, A., Belo, M. and Grunitzky, K.E. (2004) Hospitalization Charges for Patients in the Neurology Department of Lomé Teaching Hospital. Sante, 14, 109-114.
- Cossi, M.-J., Gobron, C., Preux, P.-M., Niama, D., Chabriat, H. and Houinato, D. (2012) Stroke: Prevalence and Disability in Cotonou, Benin. Cerebrovascular Diseases, 33, 166-172. https://doi.org/10.1159/000334195
- Bejot, Y., Caillier, M., Rouaud, O., Benatru, I., Maugras, C., Osseby, G.-V., et al. (2007) Epidemiology of Strokes. Impact on the Treatment Decision. La Presse médicale, 36, 117-127. https://doi.org/10.1016/j.lpm.2006.11.006
- Al Kasab, S., Derdeyn, C.P., Guerrero, W.R., Limaye, K., Shaban, A. and Adams, H.P. (2018) Intracranial Large and Medium Artery Atherosclerotic Disease and Stroke. Journal of Stroke & Cerebrovascular Diseases, 27, 1723-1732. https://doi.org/10.1016/j.jstrokecerebrovasdis.2018.02.050
- Kaddumukasa, M., Kayima, J., Nakibuuka, J., Blixen, C., Welter, E., Katabira, E., et al. (2017) Modifiable Lifestyle Risk Factors for Stroke among a High Risk Hypertensive Population in Greater Kampala, Uganda; a Cross-Sectional Study. BMC Research Notes, 10, 675. https://doi.org/10.1186/s13104-017-3009-7
- Gombert, T.R. and Ellenga, M.I.M. (2007) Facteurs de risques des accidents vasculaires cérébraux ischémiques au CHU de Brazaville. Médécine d’afrique Noire, 54, 639-645.
- Damorou, F., Togbossi, E., Pessinaba, S., Klouvi, Y., Balogou, A., Belo, M., et al. (2008) Cerebral Vascular Accidents and Embolic Cardiovascular Diseases. Le Mali Medical, 23, 31-33.
- Denolle, T., Chamontin, B., Doll, G., Fauvel, J.-P., Girerd, X., Herpin, D., et al. (2016) Management of Resistant Hypertension: Expert Consensus Statement from the French Society of Hypertension, an Affiliate of the French Society of Cardiology. Journal of Human Hypertension, 30, 657-663. https://doi.org/10.1038/jhh.2015.122