Recurrent Ischemic and Hemorrhagic Stroke in Cameroon: A Case-Control Study.

Jaurès Kamgang,Christian Wambo,Francklin Tétinou,Yvan Zolo,Chee Yang Tan,Ulrick Sidney Kanmounye,Emerancienne J N Fongang,Jeff Bronstein

doi:10.1155/2021/9948990

Abstract

Introduction Stroke recurrence accounts for a great percentage of catastrophic complications, yet no comprehensive study has analyzed the factors associated with stroke recurrence in Cameroon. We carried out this case-control study to better understand the factors associated with the stroke recurrence in Cameroon. Methods We collected sociodemographic, clinical, neuroimaging, laboratory, and therapeutic data of eligible patients who consulted the neurology and cardiology department of the Yaounde Central Hospital in Cameroon. We included all patients at least five years removed from their first stroke event who consulted the authors' institution as of January 15, 2019. Wilcoxon signed-rank and Fisher's exact tests were used. Also, a Cox regression model was used to identify confounders.Results We recruited 100 patients; seven out of ten patients had hypertension, while six out of 10 had a sedentary lifestyle. Half of the patients consumed alcohol regularly, while one patient out of five had diabetes. Most patients presented with their first stroke event, and a quarter had a stroke recurrence. Stroke recurrence was associated with right handedness (OR = 0.23, 95% CI = 0.16–0.33), congestive heart failure (OR = 3.45, 95% CI = 1.16–10.28), gout (OR = 4.34, 95% CI = 1.09–18.09), dysarthria (OR = 4.34, 95% CI = 1.30–14.54), and facial palsy (OR = 3.96, 95% CII = 1.49 – 10.51), as well as modifiable factors such as elevated abdominal circumference (P < 0.01), systolic blood pressure (P < 0.01), blood glucose level (PI <I 0.01), LDL cholesterol (P < 0.01), and triglyceride levels (P < 0.01). The mulitvariable regression model only identified laterality (B = –1.48, P = 0.04) as a statistically significant explanatory varibale for stroke recurrence. Conclusion We mapped the landscape of recurrent strokes in Cameroon. There is a need to evaluate the causes of suboptimal drug adherence rates and both the role and adherence to nonpharmacologic interventions.

Highlights

Stroke recurrence accounts for a great percentage of catastrophic complications, yet no comprehensive study has analyzed the factors associated with stroke recurrence in Cameroon
In Cameroon, the stroke recurrence rate has been estimated at 14.5% [7]. ere are several factors incriminated in stroke recurrence. ese include a history of transient ischemic attack, daily alcohol consumption, smoking, age, atrial fibrillation, and diabetes [5, 8, 9]
Ischemic strokes were in the superficial (32.0%, n = 32), deep (15.0%, n = 15), and large (10.0%, n = 10) middle cerebral artery (MCA) territories, while nine patients (9.0%) had posterior cerebral artery (PCA) strokes

Summary

Introduction

Stroke recurrence accounts for a great percentage of catastrophic complications, yet no comprehensive study has analyzed the factors associated with stroke recurrence in Cameroon. We included all patients at least five years removed from their first stroke event who consulted the authors’ institution as of January 15, 2019. Most patients presented with their first stroke event, and a quarter had a stroke recurrence. In Cameroon, the prevalence rate of stroke is 7.3%, and its mortality rates are 26.7% during the first month and 31.7% in the first three months after the stroke event [2, 3]. In Cameroon, the stroke recurrence rate has been estimated at 14.5% [7]. Despite progress in preventing and treating these factors, stroke recurrence is very prevalent and deadly [7].

Results

Discussion

Conclusion