Epidemiological, Clinical and Therapeutic Aspects of Cerebrovascular Accidents at the N’Djamena National Referral Hospital in Chad

Abstract

Introduction: Stroke is a heterogeneous group of acute neurological pathologies linked to the dysfunction, occlusion or rupture of an intracranial vascular structure. The aim of our study was to describe the epidemiological, clinical and therapeutic aspects of stroke in our context. Patients and Methods: This is a descriptive and prospective study covering a 15-month period from July 2022 to October 2023. Our study included all patients aged at least 15 years or older, admitted to the cardiology and neurology departments, with a clinical and/or CT diagnosis of stroke. This is an exhaustive sampling. Results: Out of 1173 patients admitted to the cardiology and neurology department, 203 had suffered a stroke, representing a frequency of 17.3%. The average age of patients was 59.5 years, with extremes of 15 and 85 years. The most common age group was 60 - 64, with 16.8% (n = 23) of men and 13.6% (n = 9) of women, followed by 70 - 74, with 12.4% (n = 17) of men and 19.7% of women. By sex, the age group most represented among men was 60 - 64 (16.8%) and among women 70 - 74 (19.7%). In 72.9% (n = 148) of cases, the onset of the disease was abrupt, compared with 27.1% (n = 66) with a gradual onset. Conclusion: At the end of this study carried out in N’Djamena, we can conclude that strokes are frequent and serious neurological disorders in our country. They constitute a therapeutic emergency. Treatment is marred by shortcomings due to a lack of qualified human resources. We recommend that patients avoid turning to traditional practitioners and marabouts when faced with hemiplegia, in order to better respect the 4 h 30 min treatment timeframe and improve stroke care in Chad. A subsequent study will provide a better understanding of stroke mortality in Chad, providing a window of opportunity for new therapeutic interventions.