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Review
. 2024 Apr 3:20:783-791.
doi: 10.2147/NDT.S442507. eCollection 2024.

Stroke Recurrence Rate and Risk Factors Among Stroke Survivors in Sub-Saharan Africa: A Systematic Review

Scovia Nalugo Mbalinda  1 , Mark Kaddumukasa  2 , Josephine Nambi Najjuma  3 , Martin Kaddumukasa  1   4 , Jane Nakibuuka  1   4 , Christopher J Burant  5 , Shirley Moore  6 , Carol Blixen  7 , Elly T Katabira  1 , Martha Sajatovic  7
Affiliations
Review

Stroke Recurrence Rate and Risk Factors Among Stroke Survivors in Sub-Saharan Africa: A Systematic Review

Scovia Nalugo Mbalinda et al. Neuropsychiatr Dis Treat. .

Abstract

Purpose: Evidence supporting secondary stroke in sub-Saharan Africa is scarce. This study describes the incidence of stroke recurrence and associated risk factors in sub-Saharan Africa.

Methods and materials: Scientific databases were systematically searched from January 2000 to December 2022 for population-based observational studies, case-control or cohort studies of recurrent stroke involving adults aged 18 years and above in sub-Saharan Africa (SSA). We assessed the quality of the eligible studies using the Critical Appraisal Skills Program (CASP) checklist for observational studies.

Results: Six studies met the inclusion criteria and were included in this study. Stroke recurrence rates in SSA ranged from 9.4% to 25%. Majority of the studies were conducted from Western Africa and showed that stroke recurrence rates are high within sub-Saharan Africa ranging from 2% to 25%. The known stroke risk factors such as hypertension, chronic alcohol consumption, etc., remained the leading causes of stroke recurrence. The studies reported a higher mortality rate ranging from 20.5 -23% among those with recurrent strokes compared to primary strokes.

Conclusion: This systematic review is an update and summary of the available literature on stroke recurrence within sub-Saharan Africa. Further studies are warranted to assess the outcomes and burden of stroke recurrence in SSA.

Keywords: cardiovascular disease; risk factors; secondary prevention; stroke recurrence; sub-Saharan Africa.

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Conflict of interest statement

Professor Martha Sajatovic reports grants from Merck, Otsuka, Alkermes, International Society for Bipolar Disorders (ISBD), National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), Patient-Centered Outcomes Research Institute (PCORI); personal fees from Alkermes, Otsuka, Janssen, Lundbeck, Teva, Neurelis; royalties from Springer Press, Johns Hopkins University Press, Oxford Press, UpToDate; compensation for preparation of/participation in continuing medical education activities from American Physician’s Institute (CMEtoGo), Psychopharmacology Institute, American Epilepsy Society, Clinical Care Options, American Academy of Child and Adolescent Psychiatry, Neurocrine, outside the submitted work. The authors report no other conflicts of interest in this work.

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