Abstract
BackgroundStroke is increasingly becoming a challenging public health issue in Africa, and the non-availability of data has limited research output and consequently the response to this burden. This study aimed to estimate the incidence and prevalence of stroke in Africa in 2009 towards improved policy response and management of the disease in the region.MethodsA systematic search of Medline, EMBASE and Global Health for original population-based or hospital-based studies on stroke was conducted. A random effect meta-analysis was conducted on crude stroke incidence and prevalence rates, and a meta-regression-like epidemiological model was applied on all data points. The fitted curve generated from the model was used to estimate incident cases of stroke and number of stroke survivors in Africa at midpoints of the United Nation population 5-year age groups for the year 2009.ResultsThe literature search yielded a total of 1227 studies. 19 studies from 10 African countries were selected. 483 thousand new stroke cases among people aged 15 years or more were estimated in Africa in 2009, equivalent to 81.2 (13.2–94.9)/100,000 person years. A total of 1.89 million stroke survivors among people aged 15 years or more were estimated in Africa in 2009, with a prevalence of 317.3 (314.0–748.2)/100000 population. Comparable figures for the year 2013 based on the same rates would amount to 535 thousand (87.0–625.3) new stroke cases and 2.09 million (2.06–4.93) stroke survivors, suggesting an increase of 10.8% and 9.6% of incident stroke cases and stroke survivors respectively, attributable to population growth and ageing between 2009 and 2013.ConclusionThe findings of this review suggest the burden of stroke in Africa is high and still increasing. There is need for more research on stroke and other vascular risk factors towards instituting appropriate policy, and effective preventive and management measures.
Highlights
The burden of stroke is increasing in many low- and middleincome countries (LMIC) [1], and due to high fatality rates and overwhelming resource incurred by the health systems, stroke and many non-communicable diseases (NCDs) are targeted public health priorities in these regions [2,3]
About 16 million new cases of stroke and 62 million stroke survivors were estimated in 2005, with deaths from stroke accounting for 9.7% of all global deaths, and this is expected to increase to over 23 million new stroke cases and 7.8 million stroke deaths by 2030 in the absence of significant global public health response [4,5]
It has been estimated that LMIC account for over 87% disability adjusted life years (DALYs) from stroke, which is about seven times the DALYs lost in high-income countries (HIC) [6]
Summary
The burden of stroke is increasing in many low- and middleincome countries (LMIC) [1], and due to high fatality rates and overwhelming resource incurred by the health systems, stroke and many non-communicable diseases (NCDs) are targeted public health priorities in these regions [2,3]. Between 2002 and 2004, estimates further revealed an increasing prevalence with 8% of new stroke cases and 5% of stroke survivors occurring in Africa [5,11]. Even with this increasing burden, the public health response, accesses to health services and treatment options in many African countries have been poor [7,12]. This study aimed to estimate the incidence and prevalence of stroke in Africa in 2009 towards improved policy response and management of the disease in the region
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