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. 2026 Mar:145:111828.
doi: 10.1016/j.jocn.2025.111828. Epub 2026 Jan 2.

Epidemiological trends and sex-specific disparities in stroke incidence, prevalence, years lived with disability (YLDs), and years of life lost (YLLs) across the African Union: insights from the Global Burden of Disease Study (1990-2023)

Ibrahim Khalil  1 , Sajjad Ghanim Al-Badri  2 , Md Imran Hossain  3 , Mahmuda Akter  4 , Lota Halder  5 , Sunjida Amin Promi  6 , Md Abu Sayed  7 , Arindam Das Joy  8
Affiliations

Epidemiological trends and sex-specific disparities in stroke incidence, prevalence, years lived with disability (YLDs), and years of life lost (YLLs) across the African Union: insights from the Global Burden of Disease Study (1990-2023)

Ibrahim Khalil et al. J Clin Neurosci. 2026 Mar.

Abstract

Background: Stroke imposes a substantial burden in the Africa, amplified by epidemiological transitions and limited healthcare resources. Despite global declines, sex-specific trends in incidence, prevalence, years lived with disability (YLDs), and years of life lost (YLLs) remain underexplored. This study analyzes temporal patterns in stroke burden and subtypes (ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage) across the African Union and regions from 1990 to 2023 using Global Burden of Disease (GBD) 2023 data.

Methods: Data were extracted from GBD 2023, providing age-standardized rates (ASRs) for incidence, prevalence, YLDs, and YLLs, stratified by sex and region (Central, Eastern, Northern, Southern, Western Africa). Temporal trends were quantified using estimated annual percentage changes (EAPCs) with 95% confidence intervals (CIs).

Results: Overall stroke incidence declined (EAPC -0.920; 95% CI -1.028 to -0.811), with females (-1.055; 95% CI -1.168 to -0.943) outperforming males (-0.779; 95% CI -0.883 to -0.675). Intracerebral hemorrhage incidence dropped sharply (-1.719; 95% CI -1.863 to -1.575), ischemic modestly (-0.448; 95% CI -0.548 to -0.349), and subarachnoid modestly (-0.541; 95% CI -0.605 to -0.476). Prevalence declined (-0.365; 95% CI -0.400 to -0.330), with female advantage (-0.478 vs. -0.254). YLDs decreased (-0.352; 95% CI -0.387 to -0.318), with females leading (-0.478 vs. -0.223). YLLs declined robustly (-1.059; -95% CI 1.122 to -0.996), with minimal sex difference. Northern Africa showed steepest declines (incidence EAPC -1.200; YLLs -1.989), while Southern and Central exhibited shallower trends or increases in subarachnoid subtypes.

Conclusions: The African Union's stroke burden shows modest declines, offset by regional inequities and sex disparities favoring females. Targeted interventions addressing modifiable risks and disparities are essential for equitable patient care.

Keywords: African Union; Epidemiology; Global Burden of Disease; Sex disparities; Stroke.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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