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Background: The sleep quality scale (SQS) is a comprehensive multidimensional sleep assessment scale used to evaluate sleep quality (SQ) among adults in the general population. However, the scale is yet to be validated among indigenous African populations such as in Nigeria. This study validated the factor structure and evaluated the reliability of a previously developed SQS among community-based adults in Ibadan, Nigeria., Methods: Data on SQ was extracted from 3,635 adult (≥18 years) from the Community-based Investigation of the Risk Factors for Cardiovascular Disease (COMBAT-CVDs) study. Cronbach-alpha (α) was used to evaluate the internal consistency or reliability of the SQS (>50 % cut-off), while the original 6-factor model of the SQS was explored using exploratory (≥0.5 cut-offs) and confirmatory factor analyses. The chi-square goodness of fit test and multiple fit indices were used to assess model fit at a two-sided P < 0.05., Results: Overall, the participant's mean age was 35.33±15.20 years, and 54.60 % were male. The overall reliability estimate for the SQS was 86.00 %, while the restoration after sleep subscale reliability was 93.00 %. The exploratory and confirmatory factor analysis showed that the original 6-factor model of the SQS is a more plausible model for this sample of community-based adults: comparative fit index >0.92, Tucker-Lewis index > 0.91, root mean square error of approximation ≤ 0.05., Conclusion: Our findings revealed that the SQS is promising for population-based assessment of SQ and may also assist in identifying sleep-related disorders and monitoring the efficacy of sleep treatment among indigenous Africans., (Copyright © 2024 National Medical Association. Published by Elsevier Inc. All rights reserved.)

Background: Prediction algorithms/models are viable methods for identifying individuals at high risk of stroke across diverse populations for timely intervention. However, evidence summarizing the performance of these models is limited. This study examined the performance and weaknesses of existing stroke risk-score-prediction models (SRSMs) and whether performance varied by population and region., Methods: PubMed, EMBASE, and Web of Science were searched for articles on SRSMs from the earliest records until February 2022. The Prediction Model Risk of Bias Assessment Tool was used to assess the quality of eligible articles. The performance of the SRSMs was assessed by meta-analyzing C-statistics (0 and 1) estimates from identified studies to determine the overall pooled C-statistics by fitting a linear restricted maximum likelihood in a random effect model., Results: Overall, 17 articles (cohort study = 15, nested case-control study = 2) comprising 739,134 stroke cases from 6,396,594 participants from diverse populations/regions (Asia; n = 8, United States; n = 3, and Europe and the United Kingdom; n = 6) were eligible for inclusion. The overall pooled c-statistics of SRSMs was 0.78 (95%CI: 0.75, 0.80; I 2  = 99.9%), with most SRSMs developed using cohort studies; 0.78 (95%CI: 0.75, 0.80; I 2  = 99.9%). The subgroup analyses by geographical region: Asia [0.81 (95%CI: 0.79, 0.83; I 2  = 99.8%)], Europe and the United Kingdom [0.76 (95%CI: 0.69, 0.83; I 2  = 99.9%)] and the United States only [0.75 (95%CI: 0.72, 0.78; I 2  = 73.5%)] revealed relatively indifferent performances of SRSMs., Conclusion: SRSM performance varied widely, and the pooled c-statistics of SRSMs suggested a fair predictive performance, with very few SRSMs validated in independent population group(s) from diverse world regions., Competing Interests: Declaration of competing interest All authors have no conflict of interest., (Copyright © 2024. Published by Elsevier B.V.)

Background: Hypertension is preeminent among the vascular risk factors for stroke occurrence. The wide gaps in awareness, detection, treatment, and control rates of hypertension are fueling an epidemic of stroke in sub-Saharan Africa., Purpose: To quantify the contribution of untreated, treated but uncontrolled, and controlled hypertension to stroke occurrence in Ghana and Nigeria., Methods: The Stroke Investigative Research and Educational Network (SIREN) is a case-control study across 16 study sites in Ghana and Nigeria. Cases were acute stroke (n = 3684) with age- and sex-matched stroke-free controls (n = 3684). We evaluated the associations of untreated hypertension, treated but uncontrolled hypertension, and controlled hypertension at BP of <140/90 mmHg with risk of stroke occurrence. We assessed the adjusted odds ratio and population-attributable risk of hypertension treatment control status associated with stroke occurrence., Results: The frequencies of no hypertension, untreated hypertension, treated but uncontrolled hypertension and controlled hypertension among stroke cases were 4.0%, 47.7%, 37.1%, and 9.2% vs 40.7%, 34.9%, 15.9%, and 7.7% respectively among stroke-free controls, p < 0.0001. The aOR and PAR (95% CI) for untreated hypertension were 6.58 (5.15-8.41) and 35.4% (33.4-37.4); treated but uncontrolled hypertension was 9.95 (7.60-13.02) and 35.9% (34.2-37.5); and controlled hypertension 5.37 (3.90-7.41) and 8.5% (7.6-9.5) respectively. Untreated hypertension contributed a PAR of 47.5% to the occurrence of intracerebral hemorrhage vs 29.5% for ischemic stroke. The aOR of untreated hypertension for stroke occurrence was 13.31 (7.64-23.19) for <50 years; 7.14 (4.51-11.31) for 50-64 years; and 3.48 (2.28-5.30) for 65 years or more., Conclusion: The contribution of untreated hypertension and treated but uncontrolled hypertension to stroke occurrence among indigenous Africans is substantial. Implementing targeted interventions that address gaps in hypertension prevention and treatment, involving the local population, healthcare providers, and policymakers, can potentially substantially reduce the escalating burden of strokes in Africa., Competing Interests: Declaration of competing interest We declare no competing interests., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Stroke is a leading cause of disability and mortality worldwide, but little is known about the contribution of secondhand smoke exposure (SHSE) to stroke epidemiology among indigenous Africans., Objective: To evaluate the association of SHSE with stroke among indigenous Africans., Methods: We analyzed the relationship of SHSE with stroke among 2990 case-control pairs of adults who had never smoked (identified in the SIREN study) using conditional logistic regression at a two-sided P < 0.05., Results: Multivariable-adjusted odds ratio and 95% confidence interval; 1.25 (1.04, 1.50; P = 0.02) revealed SHSE was positively associated with stroke independent of stroke subtypes., Conclusion: Culturally relevant primary prevention strategies targeted at SHSE might be promising in preventing stroke among Africans., Competing Interests: 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. The SIREN study was a multi-centre case-control study among West Africans from Nigeria and Ghana. The overall coordinating Institutional Review Board (IRB) for the SIREN study was the University of Ibadan/University College Hospital Ibadan, Nigeria (UI/EC/13/0105). IRB at all study sites approved the study, and all respondents provided written informed consent before participation in the study., (Copyright © 2022 Elsevier B.V. All rights reserved.)