DOMINANT PATTERNS OF ILLICIT SUBSTANCE USE AND ODDS OF STROKE AMONG WEST AFRICANS: FINDINGS FROM THE SIREN STUDY

Abstract

<h3>Background and Aim</h3> Illicit substance use (ISU) is a public health problem and a prominent risk factor to morbidity and mortality worldwide. However, whether ISU contributes significantly to the escalating burden of stroke in sub-Saharan Africa is yet to be clearly understood. This study assessed the relationship between ISU and the risk of stroke among indigenous Africans from Ghana and Nigeria. <h3>Methods</h3> We analyzed data, including sociodemographic, behavioural, nutritional, clinical on the patterns of ISU among 7,106 stroke case-control pairs of adults aged ≥18 years recruited into the Stroke Investigative Research and Education Network study from Nigeria and Ghana. Conditional logistic regression was applied to estimate the multivariable-adjusted odds ratio (aOR) and 95% confidence interval (CI) for risk of stroke in the light of the history of ISU at two-sided P<0.05. <h3>Results</h3> Dominant patterns of ISU between stroke cases and control included, sedatives [272(7.8%) vs 152(4.3%)], stimulants [60(1.7%) vs 62(1.5%)] and marijuana [48(1.3%) vs 24(0.6%)] respectively. History of ISU was significantly higher among stroke cases 344(9.7%) than controls 219(6.2%). History of overall ISU was not associated with stroke (aOR: 1.24; 95%CI: 0.92-1.65; P<0.15), but the use of sedatives was significantly associated with higher odds of stroke (aOR: 1.47; 95%CI: 1.04-2.07; P<0.03) after adjusting for relevant confounders. <h3>Conclusion</h3> The use of sedatives demonstrated the highest proclivity of ISU and was associated with higher odds of stroke occurrence in this population. Culturally appropriate, context-specific population-based strategies targeted at ISU would benefit stroke prevention and management in this population.