Abstract
BackgroundStroke is the second-leading global cause of death behind heart disease in 2013 and is a major cause of permanent disability. The burden of stroke in terms of mortality, morbidity and disability is increasing across the world. It is currently observed to be one of the commonest reasons of admission in many health care setups and becoming an alarming serious public health problem in our country Ethiopia. Despite the high burden of strokes globally, there is insufficient information on the current clinical profile of stroke in low and middle income countries (LMICs) including Ethiopia. So, this study was aimed to assess risk factors, clinical presentations and predictors of stroke subtypes among adult patients admitted to stroke unit of Jimma university medical center (JUMC).MethodsProspective observational study design was carried out at stroke unit (SU) of JUMC for 4 consecutive months from March 10–July 10, 2017. A standardized data extraction checklist and patient interview was used to collect data. Data was entered into Epi data version 3.1 and analyzed using SPSS version 20. Multivariable logistic regression was used to identify the predictors of stroke subtypes.ResultA total of 116 eligible stroke patients were recruited during the study period. The mean age of the patients was 55.1 ± 14.0 years and males comprised 62.9%. According to world health organization (WHO) criteria of stroke diagnosis, 51.7% of patients had ischemic while 48.3% had hemorrhagic stroke. The most common risk factor identified was hypertension (75.9%) followed by family history (33.6%), alcohol intake (22.4%), smoking (17.2%) and heart failure (17.2%). The most common clinical presentation was headache complained by 75.0% of the patients followed by aphasia 60.3% and hemiparesis 53.4%. Atrial fibrillation was the independent predictor of hemorrhagic stroke (AOR: 0.08, 95% CI: 0.01–0.68).ConclusionThe clinical characteristics of stroke in this set up were similar to other low- and middle-resource countries. As stroke is a high priority chronic disease, large-scale public health campaign should be launched focusing on public education regarding stroke risk factors and necessary interventions.
Highlights
Stroke is the second-leading global cause of death behind heart disease in 2013 and is a major cause of permanent disability
As stroke is a high priority chronic disease, large-scale public health campaign should be launched focusing on public education regarding stroke risk factors and necessary interventions
Hemorrhagic stroke patients were more likely to be presented with coma (P = 0.033), vomiting (P = 0.028) and neck stiffness (p = 0.015), but ischemic stroke patients were more likely presented with chest pain (p = 0.016)
Summary
Stroke is the second-leading global cause of death behind heart disease in 2013 and is a major cause of permanent disability. The burden of stroke in terms of mortality, morbidity and disability is increasing across the world. Despite the high burden of strokes globally, there is insufficient information on the current clinical profile of stroke in low and middle income countries (LMICs) including Ethiopia. The burden of stroke in terms of mortality, morbidity and disability is increasing across the world [8, 9]. Data from Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) of 2010 revealed that stroke is the leading cardiovascular disease (CVD) which causes mortality and disability in sub-Saharan Africa (SSA) and other low and middle income countries (LMICs) [10]. The poor are increasingly affected by stroke, which can be attributable to the changing population exposures to risk factors and inability to afford the high cost of stroke care [14]. Only little data about context-specific risk factors for prioritizing interventions to reduce the stroke burden in subSaharan Africa is available [15, 16]
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