139 results on '"Obiako, Reginald"'
Search Results
102. Biobanking in a Challenging African Environment: Unique Experience from the SIREN Project.
- Author
-
Akinyemi, Rufus O., Akinwande, Kazeem, Diala, Samuel, Adeleye, Osi, Ajose, Abiodun, Issa, Kehinde, Owusu, Dorcas, Boamah, Isaac, Yahaya, Isah Suleiman, Jimoh, Abdulraheem Olayemi, Imoh, Lucius, Fakunle, Gregory, Akpalu, Albert, Sarfo, Fred, Wahab, Kolawole, Sanya, Emmanuel, Owolabi, Lukman, Obiako, Reginald, Osaigbovo, Godwin, and Komolafe, Morenikeji
- Abstract
Africa was previously insufficiently represented in the emerging discipline of biobanking despite commendable early efforts. However, with the Human, Heredity, and Health in Africa (H3Africa) initiative, biorepository science has been bolstered, regional biobanks are springing up, and awareness about biobanks is growing on the continent. The Stroke Investigative Research and Educational Network (SIREN) project is a transnational, multicenter, hospital and community-based study involving over 3000 cases and 3000 controls recruited from 16 sites in Ghana and Nigeria. SIREN aims to explore and unravel the genetic and environmental factors that interact to produce the peculiar phenotypic and clinical characteristics of stroke as seen in people of African ancestry and facilitate the development of new diagnostics, therapeutics, and preventative strategies. The aim of this article is to describe our experience with the development of the procedure for collection, processing, storage, and shipment of biological samples (blood, serum, plasma, buffy coat, red cell concentrates, and DNA) and brain imaging across coordinating and participating sites within the SIREN Project. The SIREN network was initiated in 2014 with support and funding from the H3Africa Initiative. The SIREN Biobank currently has 3015 brain images, 92,950 blood fractions (serum, plasma, red cell concentrates, and buffy coat) accrued from 8450 recruited subjects, and quantified and aliquoted good-quality DNA extracts from 6150 study subjects. This represents an invaluable resource for future research with expanding genomic and trans-omic technologies. This will facilitate the involvement of indigenous African samples in cutting-edge stroke genomics and trans-omics research. It is, however, critical to effectively engage African stroke patients and community members who have contributed precious biological materials to the SIREN Biobank to generate appropriate evidence base for dealing with ethical, legal, and social issues of privacy, autonomy, identifiability, biorights, governance issues, and public understanding of stroke biobanking in the context of unique African culture, language, and belief systems. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
103. An evaluation of psychological distress and social support of survivors and contacts of Ebola virus disease infection and their relatives in Lagos, Nigeria: a cross sectional study − 2014
- Author
-
Mohammed, Abdulaziz, primary, Sheikh, Taiwo Lateef, additional, Gidado, Saheed, additional, Poggensee, Gabriele, additional, Nguku, Patrick, additional, Olayinka, Adebola, additional, Ohuabunwo, Chima, additional, Waziri, Ndadilnasiya, additional, Shuaib, Faisal, additional, Adeyemi, Joseph, additional, Uzoma, Ogbonna, additional, Ahmed, Abubakar, additional, Doherty, Funmi, additional, Nyanti, Sarah Beysolow, additional, Nzuki, Charles Kyalo, additional, Nasidi, Abdulsalami, additional, Oyemakinde, Akin, additional, Oguntimehin, Olukayode, additional, Abdus-salam, Ismail Adeshina, additional, and Obiako, Reginald O., additional
- Published
- 2015
- Full Text
- View/download PDF
104. Pattern and outcome of tetanus in a tertiary health facility in Northwest Nigeria.
- Author
-
ALIYU, ALHAJI A., DAHIRU, TUKUR, OBIAKO, REGINALD O., AMADU, LAWAL, BILIAMINU, LAWAL B., and AKASE, EPHRAIM I.
- Published
- 2017
- Full Text
- View/download PDF
105. Clinical Presentation and Outcome of Toxoplasma Encephalitis in HIV-Infected Patients from Zaria, Northern Nigeria
- Author
-
Ogoina, Dimie, primary, Obiako, Reginald O., additional, Onyemelukwe, Geoffrey C., additional, Musa, Bolanle O., additional, and Hamidu, Ahmed Umdagas, additional
- Published
- 2013
- Full Text
- View/download PDF
106. Seroprevalence of IgM and IgG Antibodies to Toxoplasma infection in healthy and HIV-positive adults from Northern Nigeria
- Author
-
Ogoina, Dimie, primary, Onyemelukwe, Geoffrey C, additional, Musa, Bolanle O, additional, and Obiako, Reginald O, additional
- Published
- 2013
- Full Text
- View/download PDF
107. Phenotyping Stroke in Sub-Saharan Africa: Stroke Investigative Research and Education Network (SIREN) Phenomics Protocol.
- Author
-
akpalu, albert, Sarfo, Fred Stephen, Ovbiagele, Bruce, akinyemi, Rufus, Gebregziabher, Mulugeta, Obiako, Reginald, Owolabi, Lukman, Sagoe, Kwamena, Jenkins, Carolyn, arulogun, Oyedunni, adamu, Sheila, appiah, Lambert T., adadey, Martin a., agyekum, Francis, Quansah, Joseph a., Mensah, Yaw B., adeoye, abiodun M., Singh, arti, Tosin, aridegbe O., and Ohifemen, Osimhiarherhuo
- Abstract
Background: As the second leading cause of death and the leading cause of adult-onset disability, stroke is a major public health concern particularly pertinent in Sub-Saharan Africa (SSA), where nearly 80% of all global stroke mortalities occur, and stroke burden is projected to increase in the coming decades. However, traditional and emerging risk factors for stroke in SSA have not been well characterized, thus limiting efforts at curbing its devastating toll. The Stroke Investigative Research and Education Network (SIREN) project is aimed at comprehensively evaluating the key environmental and genomic risk factors for stroke (and its subtypes) in SSA while simultaneously building capacities in phenomics, biobanking, genomics, biostatistics, and bioinformatics for brain research. Methods: SIREN is a transnational, multicentre, hospital and community-based study involving 3,000 cases and 3,000 controls recruited from 8 sites in Ghana and Nigeria. Cases will be hospital-based patients with first stroke within 10 days of onset in whom neurovascular imaging will be performed. Etiological and topographical stroke subtypes will be documented for all cases. Controls will be hospital- and community-based participants, matched to cases on the basis of gender, ethnicity, and age (±5 years). Information will be collected on known and proposed emerging risk factors for stroke. Study Significance: SIREN is the largest study of stroke in Africa to date. It is anticipated that it will shed light on the phenotypic characteristics and risk factors of stroke and ultimately provide evidence base for strategic interventions to curtail the burgeoning burden of stroke on the sub-continent. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
108. Morbidity and Mortality Patterns of Hospitalised Adult HIV/AIDS Patients in the Era of Highly Active Antiretroviral Therapy: A 4-year Retrospective Review from Zaria, Northern Nigeria
- Author
-
Ogoina, Dimie, primary, Obiako, Reginald O., additional, Muktar, Haruna M., additional, Adeiza, Mukhtar, additional, Babadoko, Aliyu, additional, Hassan, Abdulaziz, additional, Bansi, Isa, additional, Iheonye, Henry, additional, Iyanda, Matthew, additional, and Tabi-Ajayi, Eric, additional
- Published
- 2012
- Full Text
- View/download PDF
109. HIV Wasting Syndrome in a Nigerian Failing Antiretroviral Therapy: A Case Report and Review of the Literature
- Author
-
Ogoina, Dimie, primary, Obiako, Reginald O., additional, and Muktar, Haruna M., additional
- Published
- 2010
- Full Text
- View/download PDF
110. An evaluation of psychological distress and social support of survivors and contacts of Ebola virus disease infection and their relatives in Lagos, Nigeria: a cross sectional study - 2014.
- Author
-
Mohammed, Abdulaziz, Sheikh, Taiwo Lateef, Gidado, Saheed, Poggensee, Gabriele, Nguku, Patrick, Olayinka, Adebola, Ohuabunwo, Chima, Waziri, Ndadilnasiya, Shuaib, Faisal, Adeyemi, Joseph, Uzoma, Ogbonna, Ahmed, Abubakar, Doherty, Funmi, Nyanti, Sarah Beysolow, Nzuki, Charles Kyalo, Nasidi, Abdulsalami, Oyemakinde, Akin, Oguntimehin, Olukayode, Abdus-salam, Ismail Adeshina, and Obiako, Reginald O.
- Abstract
Background: By September 2014, an outbreak of Ebola Viral Disease (EVD) in West African countries of Guinea, Liberia, Sierra Leone, Senegal and Nigeria, had recorded over 4500 and 2200 probable or confirmed cases and deaths respectively. EVD, an emerging infectious disease, can create fear and panic among patients, contacts and relatives, which could be a risk factor for psychological distress. Psychological distress among this subgroup could have public health implication for control of EVD, because of potential effects on patient management and contact tracing. We determined the Prevalence, pattern and factors associated with psychological distress among survivors and contacts of EVD and their relatives. Methods: In a descriptive cross sectional study, we used General Health Questionnaire to assess psychological distress and Oslo Social Support Scale to assess social support among 117 participants who survived EVD, listed as EVD contacts or their relatives at Ebola Emergency Operation Center in Lagos, Nigeria. Factors associated with psychological distress were determined using chi square/odds ratio and adjusted odds ratio. Results: The mean age and standard deviation of participants was 34 +/ - 9.6 years. Of 117 participants, 78 (66.7 %) were females, 77 (65.8 %) had a tertiary education and 45 (38.5 %) were health workers. Most frequently occurring psychological distress were inability to concentrate (37.6 %) and loss of sleep over worry (33.3 %). Losing a relation to EVD outbreak (OR = 6.0, 95 % CI, 1.2-32.9) was significantly associated with feeling unhappy or depressed while being a health worker was protective (OR = 0.4, 95 % CI, 0.2-0.9). Adjusted Odds Ratio (AOR) showed losing a relation (AOR = 5.7, 95 % CI, 1.2-28.0) was a predictor of "feeling unhappy or depressed", loss of a relation (AOR = 10.1, 95 % CI, 1.7-60.7) was a predictor of inability to concentrate. Conclusions: Survivors and contacts of EVD and their relations develop psychological distress. Development of psychological distress could be predicted by loss of family member. It is recommended that psychiatrists and other mental health specialists be part of case management teams. The clinical teams managing EVD patients should be trained on recognition of common psychological distress among patients. A mental health specialist should review contacts being monitored for EVD for psychological distress or disorders. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
111. Clinical Presentation and Outcome of Toxoplasma Encephalitis in HIV-Infected Patients from Zaria, Northern Nigeria: A Case Series of 9 Patients.
- Author
-
Ogoina, Dimie, Obiako, Reginald O., Onyemelukwe, Geoffrey C., Musa, Bolanle O., and Hamidu, Ahmed Umdagas
- Published
- 2014
- Full Text
- View/download PDF
112. Abstract WP226: Secondhand Smoking And Odds Of Stroke Among Non-smoking Indigenous Africans From Ghana And Nigeria: A Matched Case-control Study
- Author
-
Owolabi, Mayowa P, Asowata, Osahon J, Fakunle, Adekunle, Akpa, Onoja M, SARFO, FRED S, Akpalu, Albert, Wahab, Kolawole, Obiako, Reginald, Komolafe, Morenikeji, Owolabi, Lukman, Osaigbovo, Godwin, Akinyemi, Rufus O, Ovbiagele, Bruce, and Owolabi, Mayowa
- Abstract
Introduction:Second-hand smoking (SHS) is an emerging phenomenon in cardiovascular disease (CVD) epidemiology, but whether SHS is associated with stroke is not clearly understood. We assessed the association between SHS and stroke risk in a cohort of West Africans in the Stroke Investigative Research and Educational Network (SIREN) study.Hypothesis:SHS is not associated with stroke among indigenous West Africans from Ghana and Nigeria.Methods:3131 stroke cases who had never smoked matched (for age and sex) with 3131 healthy smoke-free controls were identified in the multi-centre SIREN study in Ghana and Nigeria. Information on SHS was obtained through the collection of data on regular exposure to exhaled smoke or burning tobacco in an indoor environment. We assessed the relationship between SHS and stroke by estimating the odds ratio (OR) and 95% confidence interval (CI) using conditional logistic regression, adjusting for relevant covariates at P<0.05 in a two-sided test.Results:The mean age of the participants was 58.8±14.1years (males, 48.0%). History of exposure to SHS was present in 20.2% of the overall sample. The multivariable-adjusted OR for the association between SHS and all stroke events was 1.12 (0.93, 1.34), P= 0.210. When the association was stratified by stroke type, the multivariable-adjusted OR were 1.42 (1.03, 1.98) P= 0.033 for haemorrhagic stroke and 1.01 (0.80, 1.26) P= 0.935 for ischaemic stroke.Conclusion(s):SHS was independently associated with higher odds of haemorrhagic stroke, but not ischaemic stroke in this cohort of indigenous West Africans. Intervention(s) to reduce SHS might help lower the burden of stroke in this population, pending longitudinal studies to evaluate the causal effect of SHS on stroke.
- Published
- 2022
- Full Text
- View/download PDF
113. Abstract WP211: Dietary Patterns And Blood Pressure Profiles Among Stroke-free Africans: Evidence From The Stroke Investigative Research And Educational Network Study In Sub-Saharan Africa.
- Author
-
Okekunle, Akinkunmi P, Asowata, Osahon J, Owolabi, Ayomide, Fakunle, Adekunle, Akpa, Onoja M, SARFO, FRED S, Akpalu, Albert, Wahab, Kolawole, Obiako, Reginald, Komolafe, Morenikeji, Owolabi, Lukman, Osaigbovo, Godwin, Akinyemi, Rufus O, Ovbiagele, Bruce, and Owolabi, Mayowa
- Abstract
Introduction:High blood pressure is a prominent risk factor for stroke in Sub-Saharan Africa (SSA) where dietary factors associated with blood pressure are often under-reported.Hypothesis:Dietary patterns (DP) are not associated with systolic blood pressure (SBP) and diastolic blood pressure (DBP) among stroke-free Africans from Ghana and Nigeria.Methods:Information on diet history (including servings and frequency of consumption) was collected from 4,413 stroke-free persons (recruited from Nigeria and Ghana) and transformed using principal component analysis to estimate seven distinct factor scores that represented seven DP. SBP and DBP measurements were taken using standard operating procedures and linear regression models (adjusting for age, sex, smoking and alcohol use) were applied to estimate beta (β) coefficients and 95% confidence interval (CI) for the association of the DP (using the factor scores) with SBP and DBP at P<0.05.Results:Mean age was 56.18±14.90years, 48.6% were females, 6.1% reported ever smoked cigarette and 24,8% reported alcohol use. Mean SBP and DBP were 135.53±24.21mmHg and 82.62±14.27mmHg respectively. Seven dietary patterns ('Vegetables', 'Sweetened food&Carbonated drinks', 'Organ & Red meat', 'Processed foods', 'Dairy, Legumes&Whole grains', 'Potatoes, Refined grains&Fish' and 'Fried&Salty foods') were identified in this sample. Overall, factors scores of DP were not significantly associated with SBP, but DBP was significantly reduced by factors of 'Vegetables' patterns (β = -0.60; 95% CI: -1.02, -0.18, P=0.005), 'Dairy, Legume&Whole grain' patterns (β = -0.50; 95% CI: -0.92, -0.06, P=0.019) and Potatoes, Refined grains & Fish patterns (β = -0.54 (-0.99, 95% CI: -0.10, P=0.016).Conclusion(s):Adherence to plant-based diets was associated with reduced blood pressure particularly diastolic blood pressure. The association between DP and blood pressure may be complex but dietary advisory encouraging the consumption of plant-based diets may be helpful in the primary prevention of high blood pressure in this population.
- Published
- 2022
- Full Text
- View/download PDF
114. Psychometric validity of the distress thermometer and problem check list in ART-naïve HIV infected patients in Northern Nigeria
- Author
-
Obiajulu, Victor Olisah, primary, Abiola, Tajudeen, additional, Izehinosen, Christopher Okpataku, additional, Obiako, Reginald O, additional, Aveka, Ishaq Audu, additional, Adam, Bashir Yakasai, additional, and Lateef, Taiwo Sheikh, additional
- Published
- 1970
- Full Text
- View/download PDF
115. Abstract TP166: The Topmost Modifiable Risk Factors for Stroke Among People of African Ancestry.
- Author
-
Owolabi, Mayowa O, Sarfo, Fred S, Akpa, Onoja, Gebregziabher, Mulugeta, Akinyemi, Rufus, Armstrong, Kevin, Akpalu, Albert, Tiwari, Hemant, Arnett, Donna, Obiako, Reginald, Owolabi, Lukman, Wahab, Kolawole, Melikam, Ezinne S, Saulsom, Raelle, Lackland, Dan, Jenkins, Carolyn, Arulogun, Omoyisola, and Ovbiagele, Bruce
- Published
- 2017
- Full Text
- View/download PDF
116. Clinical presentation and outcome of severe malaria in adults in Zaria, Northern Nigeria.
- Author
-
Ogoina, Dimie and Obiako, Reginald O.
- Subjects
- *
MALARIA , *IMMUNITY , *ADOLESCENCE , *HIV infections , *ACUTE diseases - Abstract
The article discusses the clinical outcome of severe malaria in adults in Zaria, Northern Nigeria. In Nigeria, transmissions of malaria results in the development of partial malarial immunity from childhood that provides protection against severe diseases during adolescence and adulthood. It also informs that delay in effective anti-malarial therapy and advanced HIV-1 infection are said to be possible predisposing factors for severe malaria.
- Published
- 2012
- Full Text
- View/download PDF
117. Peculiarities of genital ulcer diseases in HIV-infected patients: Report of four cases from Zaria, Nigeria.
- Author
-
Ogoina, Dimie, Muktar, Haruna M., and Obiako, Reginald O.
- Subjects
GENITAL diseases ,HIV-positive persons ,ANTIVIRAL agents ,DISEASES - Abstract
The article presents a case study of four case studies of genital ulcer diseases (GUDs) among the HIV-infected patients in northern Nigeria. The cases are in line with the other studies suggesting that GUDs in HIV-infected patients were aggressive, chronic, recurrent, and sometimes related with systemic symptoms. It points out that highly active antiretroviral therapy (HAART) improves GUD recovery and prevents its recurrence.
- Published
- 2011
- Full Text
- View/download PDF
118. Disseminated infections due to Immune Reconstitution Inflammatory Syndrome after Highly Active Antiretroviral Therapy - Report of 3 cases from Nigeria.
- Author
-
Ogoina, Dimie, Adekunle, Victor, Obiako, Reginald, Umar, Abdulaziz, Akolawole, Michael, and Ovosi, Joseph
- Abstract
Immune Reconstitution Inflammatory Syndromes (IRIS) are exaggerated pathological inflammatory reactions occurring after initiation of highly active antiretroviral therapy (HAART) due to exuberant immune responses to occult or apparent opportunistic infections or cancers. In view of paucity of studies from Nigeria, we report 3 cases of IRIS presenting as disseminated infections in HIV-1 infected patients initiating HAART. The first case was a previously healthy female who developed disseminated tuberculosis after 4 weeks of regular HAART. Her HAART regimen was continued and she improved after commencement of anti-tuberculosis drugs, with evidence of progressive increase in CD4 cell count. The second case was a HAART-experienced female who stopped her drugs for 4months. Two months after recommencement of her previous HAART regimen, she developed features of disseminated herpes zoster infection, despite evidence of decrease in viral load by 95%. HAART was continued and she recovered completely after receiving valaciclovir tablets and antibiotics. The third patient was a female student who was commenced HAART on account of chronic cough and weight loss. Three months after regular HAART, she developed features of disseminated Kaposi's sarcoma involving the skin, oropharynx and lungs, despite evidence of 42% increase in CD4 cell count. Unfortunately, she rapidly deteriorated and died during the course of management. Clinicians should be alert to the possibility of IRIS in HIV-infected patients initiated or re-initiated on HAART. There is need for future prospective studies determining risk factors for IRIS in HIV-infected patients from Nigeria. [ABSTRACT FROM AUTHOR]
- Published
- 2011
119. Publisher Correction : Stroke genetics informs drug discovery and risk prediction across ancestries
- Author
-
Mishra, Aniket, Malik, Rainer, He, Yunye, Rosand, Jonathan, Sabatine, Marc S, Sacco, Ralph L, Saleheen, Danish, Sandset, Else Charlotte, Salomaa, Veikko, Sargurupremraj, Muralidharan, Sasaki, Makoto, Satizabal, Claudia L, Schmidt, Carsten O, Georgakis, Marios K, Shimizu, Atsushi, Smith, Nicholas L, Sloane, Kelly L, Sutoh, Yoichi, Sun, Yan V, Tanno, Kozo, Tiedt, Steffen, Tatlisumak, Turgut, Torres-Aguila, Nuria P, Tiwari, Hemant K, Caro, Ilana, Trégouët, David-Alexandre, Trompet, Stella, Tuladhar, Anil Man, Tybjærg-Hansen, Anne, van Vugt, Marion, Vibo, Riina, Verma, Shefali S, Wiggins, Kerri L, Wennberg, Patrik, Woo, Daniel, Krebs, Kristi, Wilson, Peter W F, Xu, Huichun, Yang, Qiong, Yoon, Kyungheon, Consortium, COMPASS, Consortium, INVENT, Initiative, Dutch Parelsnoer, Biobank, Estonian, Consortium, PRECISE4Q, Consortium, FinnGen, Liaw, Yi-Ching, Network, NINDS Stroke Genetics, Consortium, MEGASTROKE, Consortium, SIREN, Group, China Kadoorie Biobank Collaborative, Program, VA Million Veteran, Consortium, International Stroke Genetics, Japan, Biobank, Consortium, CHARGE, Consortium, GIGASTROKE, Millwood, Iona Y, Vaura, Felix C, Gieger, Christian, Ninomiya, Toshiharu, Grabe, Hans J, Jukema, J Wouter, Rissanen, Ina L, Strbian, Daniel, Kim, Young Jin, Chen, Pei-Hsin, Mayerhofer, Ernst, Howson, Joanna M M, Lin, Kuang, Irvin, Marguerite R, Adams, Hieab, Wassertheil-Smoller, Sylvia, Christensen, Kaare, Ikram, Mohammad A, Rundek, Tatjana, Worrall, Bradford B, Lathrop, G Mark, Riaz, Moeen, Simonsick, Eleanor M, Winsvold, Bendik Slagsvold, Kõrv, Janika, França, Paulo H C, Zand, Ramin, Prasad, Kameshwar, Frikke-Schmidt, Ruth, de Leeuw, Frank-Erik, Liman, Thomas G., Haeusler, Karl Georg, Ruigrok, Ynte M, Heuschmann, Peter Ulrich, Srinivasasainagendra, Vinodh, Longstreth, W. T., Jung, Keum Ji, Bastarache, Lisa, Paré, Guillaume, Damrauer, Scott M, Chasman, Daniel I, Rotter, Jerome I, Anderson, Christopher D, Zwart, John-Anker, Niiranen, Teemu J, Parodi, Livia, Fornage, Myriam, Liaw, Yung-Po, Seshadri, Sudha, Fernández-Cadenas, Israel, Walters, Robin G, Ruff, Christian T, Owolabi, Mayowa O, Huffman, Jennifer E, Milani, Lili, Kamatani, Yoichiro, Hachiya, Tsuyoshi, Bae, Hee-Joon, Dichgans, Martin, Debette, Stephanie, Chauhan, Ganesh, Chong, Michael R, Tomppo, Liisa, Akinyemi, Rufus, Roshchupkin, Gennady V, Habib, Naomi, Jee, Yon Ho, Thomassen, Jesper Qvist, Abedi, Vida, Jürgenson, Tuuli, Cárcel-Márquez, Jara, Nygaard, Marianne, Leonard, Hampton L, Yang, Chaojie, Yonova-Doing, Ekaterina, Knol, Maria J, Lewis, Adam J, Judy, Renae L, Ago, Tetsuro, Amouyel, Philippe, Namba, Shinichi, Armstrong, Nicole D, Bakker, Mark K, Bartz, Traci M, Bennett, David A, Bis, Joshua C, Bordes, Constance, Børte, Sigrid, Cain, Anael, Ridker, Paul M, Cho, Kelly, Posner, Daniel C, Chen, Zhengming, Cruchaga, Carlos, Cole, John W, de Jager, Phil L, de Cid, Rafael, Endres, Matthias, Ferreira, Leslie E, Geerlings, Mirjam I, Gasca, Natalie C, Gudnason, Vilmundur, Kamanu, Frederick K, Hata, Jun, He, Jing, Heath, Alicia K, Ho, Yuk-Lam, Havulinna, Aki S, Hopewell, Jemma C, Hyacinth, Hyacinth I, Inouye, Michael, Jacob, Mina A, Jeon, Christina E, Koido, Masaru, Jern, Christina, Kamouchi, Masahiro, Keene, Keith L, Kitazono, Takanari, Kittner, Steven J, Konuma, Takahiro, Kumar, Amit, Lacaze, Paul, Launer, Lenore J, Lee, Keon-Joo, Le Grand, Quentin, Lepik, Kaido, Li, Jiang, Li, Liming, Manichaikul, Ani, Markus, Hugh S, Marston, Nicholas A, Meitinger, Thomas, Mitchell, Braxton D, Montellano, Felipe A, Morisaki, Takayuki, Shi, Mingyang, Mosley, Thomas H, Nalls, Mike A, Nordestgaard, Børge G, O'Donnell, Martin J, Okada, Yukinori, Onland-Moret, N Charlotte, Ovbiagele, Bruce, Peters, Annette, Psaty, Bruce M, Rich, Stephen S, Bis, Joshua C, Lee, Jin-Moo, Cheng, Yu-Ching, Meschia, James F, Chen, Wei Min, Sale, Michèle M, Zonderman, Alan B, Evans, Michele K, Wilson, James G, Correa, Adolfo, Traylor, Matthew, Lewis, Cathryn M, Carty, Cara L, Reiner, Alexander, Haessler, Jeffrey, Langefeld, Carl D, Gottesman, Rebecca F, Yaffe, Kristine, Liu, Yong Mei, Kooperberg, Charles, Lange, Leslie A, Furie, Karen L, Arnett, Donna K, Benavente, Oscar R, Grewal, Raji P, Peddareddygari, Leema Reddy, Hveem, Kristian, Lindstrom, Sara, Wang, Lu, Smith, Erin N, Gordon, William, van Hylckama Vlieg, Astrid, de Andrade, Mariza, Brody, Jennifer A, Pattee, Jack W, Brumpton, Ben M, Suchon, Pierre, Chen, Ming-Huei, Frazer, Kelly A, Turman, Constance, Germain, Marine, MacDonald, James, Braekkan, Sigrid K, Armasu, Sebastian M, Pankratz, Nathan, Jackson, Rebecca D, Nielsen, Jonas B, Giulianini, Franco, Puurunen, Marja K, Ibrahim, Manal, Heckbert, Susan R, Bammler, Theo K, McCauley, Bryan M, Taylor, Kent D, Pankow, James S, Reiner, Alexander P, Gabrielsen, Maiken E, Deleuze, Jean-François, O'Donnell, Chris J, Kim, Jihye, McKnight, Barbara, Kraft, Peter, Hansen, John-Bjarne, Rosendaal, Frits R, Heit, John A, Tang, Weihong, Morange, Pierre-Emmanuel, Johnson, Andrew D, Kabrhel, Christopher, van Dijk, Ewoud J, Koudstaal, Peter J, Luijckx, Gert-Jan, Nederkoorn, Paul J, van Oostenbrugge, Robert J, Visser, Marieke C, Wermer, Marieke J H, Kappelle, L Jaap, Esko, Tõnu, Metspalu, Andres, Mägi, Reedik, Nelis, Mari, Irvin, Marguerite R, de Leeuw, Frank-Erik, Levi, Christopher R, Maguire, Jane, Jiménez-Conde, Jordi, Sharma, Pankaj, Sudlow, Cathie L M, Rannikmäe, Kristiina, Schmidt, Reinhold, Slowik, Agnieszka, Pera, Joanna, Thijs, Vincent N S, Lindgren, Arne G, Ilinca, Andreea, Melander, Olle, Engström, Gunnar, Rexrode, Kathryn M, Rothwell, Peter M, Stanne, Tara M, Johnson, Julie A, Danesh, John, Butterworth, Adam S, Heitsch, Laura, Boncoraglio, Giorgio B, Kubo, Michiaki, Pezzini, Alessandro, Rolfs, Arndt, Giese, Anne-Katrin, Weir, David, Ross, Owen A, Lemmons, Robin, Soderholm, Martin, Cushman, Mary, Jood, Katarina, McDonough, Caitrin W, Bell, Steven, Linkohr, Birgit, Lee, Tsong-Hai, Putaala, Jukka, Anderson, Christopher D, Lopez, Oscar L, Jian, Xueqiu, Schminke, Ulf, Cullell, Natalia, Delgado, Pilar, Ibañez, Laura, Krupinski, Jerzy, Lioutas, Vasileios, Matsuda, Koichi, Montaner, Joan, Muiño, Elena, Roquer, Jaume, Sarnowski, Chloe, Sattar, Naveed, Sibolt, Gerli, Teumer, Alexander, Rutten-Jacobs, Loes, Kanai, Masahiro, Gretarsdottir, Solveig, Rost, Natalia S, Yusuf, Salim, Almgren, Peter, Ay, Hakan, Bevan, Steve, Brown, Robert D, Carrera, Caty, Buring, Julie E, Chen, Wei-Min, Cotlarciuc, Ioana, de Bakker, Paul I W, DeStefano, Anita L, den Hoed, Marcel, Duan, Qing, Engelter, Stefan T, Falcone, Guido J, Gustafsson, Stefan, Hassan, Ahamad, Holliday, Elizabeth G, Howard, George, Hsu, Fang-Chi, Ingelsson, Erik, Harris, Tamara B, Kissela, Brett M, Kleindorfer, Dawn O, Langenberg, Claudia, Lemmens, Robin, Leys, Didier, Lin, Wei-Yu, Lorentzen, Erik, Magnusson, Patrik K, McArdle, Patrick F, Pulit, Sara L, Rice, Kenneth, Sakaue, Saori, Sapkota, Bishwa R, Tanislav, Christian, Thorleifsson, Gudmar, Thorsteinsdottir, Unnur, Tzourio, Christophe, van Duijn, Cornelia M, Walters, Matthew, Wareham, Nicholas J, Amin, Najaf, Aparicio, Hugo J, Attia, John, Beiser, Alexa S, Berr, Claudine, Bustamante, Mariana, Caso, Valeria, Choi, Seung Hoan, Chowhan, Ayesha, Dartigues, Jean-François, Delavaran, Hossein, Dörr, Marcus, Ford, Ian, Gurpreet, Wander S, Hamsten, Anders, Hozawa, Atsushi, Ingelsson, Martin, Iwasaki, Motoki, Kaffashian, Sara, Kalra, Lalit, Kjartansson, Olafur, Kloss, Manja, Labovitz, Daniel L, Laurie, Cathy C, Li, Linxin, Lind, Lars, Lindgren, Cecilia M, Makoto, Hirata, Minegishi, Naoko, Morris, Andrew P, Müller-Nurasyid, Martina, Norrving, Bo, Ogishima, Soichi, Parati, Eugenio A, Pedersen, Nancy L, Perola, Markus, Jousilahti, Pekka, Pileggi, Silvana, Rabionet, Raquel, Riba-Llena, Iolanda, Ribasés, Marta, Romero, Jose R, Rudd, Anthony G, Sarin, Antti-Pekka, Sarju, Ralhan, Satoh, Mamoru, Sawada, Norie, Sigurdsson, Ásgeir, Smith, Albert, Stine, O Colin, Stott, David J, Strauch, Konstantin, Takai, Takako, Tanaka, Hideo, Touze, Emmanuel, Tsugane, Shoichiro, Uitterlinden, Andre G, Valdimarsson, Einar M, van der Lee, Sven J, Wakai, Kenji, Williams, Stephen R, Wolfe, Charles D A, Wong, Quenna, Yamaji, Taiki, Sanghera, Dharambir K, Stefansson, Kari, Martinez-Majander, Nicolas, Sobue, Kenji, Soriano-Tárraga, Carolina, Völzke, Henry, Akpa, Onoja, Sarfo, Fred S, Akpalu, Albert, Obiako, Reginald, Wahab, Kolawole, Osaigbovo, Godwin, Owolabi, Lukman, Komolafe, Morenikeji, Jenkins, Carolyn, Arulogun, Oyedunni, Ogbole, Godwin, Adeoye, Abiodun M, Akinyemi, Joshua, Agunloye, Atinuke, Fakunle, Adekunle G, Uvere, Ezinne, Olalere, Abimbola, Adebajo, Olayinka J, Chen, Junshi, Clarke, Robert, Collins, Rory, Guo, Yu, Wang, Chen, Lv, Jun, Peto, Richard, Chen, Yiping, Fairhurst-Hunter, Zammy, Hill, Michael, Pozarickij, Alfred, Schmidt, Dan, Stevens, Becky, Turnbull, Iain, Yu, Canqing, Le Grand, Quentin, Ferreira, Leslie E, Nagai, Akiko, Murakami, Yoishinori, Geerlings, Mirjam I, Gasca, Natalie C, Gudnason, Vilmundur, van Vugt, Marion, Shiroma, Eric J, Sigurdsson, Sigurdur, Ghanbari, Mohsen, Boerwinkle, Eric, Fongang, Bernard, Wang, Ruiqi, Ikram, Mohammad K, Völker, Uwe, de Jager, Phil L, de Cid, Rafael, Nordestgaard, Børge G, Sargurupremraj, Muralidharan, Verma, Shefali S, de Laat, Karlijn F, van Norden, Anouk G W, de Kort, Paul L, Vermeer, Sarah E, Brouwers, Paul J A M, Gons, Rob A R, den Heijer, Tom, van Dijk, Gert W, van Rooij, Frank G W, Aamodt, Anne H, Skogholt, Anne H, Willer, Cristen J, Heuch, Ingrid, Hagen, Knut, Fritsche, Lars G, Pedersen, Linda M, Ellekjær, Hanne, Zhou, Wei, Martinsen, Amy E, Kristoffersen, Espen S, Thomas, Laurent F, Kleinschnitz, Christoph, Frantz, Stefan, Ungethüm, Kathrin, Gallego-Fabrega, Cristina, Lledós, Miquel, Llucià-Carol, Laia, Sobrino, Tomas, Campos, Francisco, Castillo, José, Freijó, Marimar, Arenillas, Juan Francisco, Obach, Victor, Álvarez-Sabín, José, Molina, Carlos A, Ribó, Marc, Muñoz-Narbona, Lucia, Lopez-Cancio, Elena, Millán, Mònica, Diaz-Navarro, Rosa, Vives-Bauza, Cristòfol, Serrano-Heras, Gemma, Segura, Tomás, Dhar, Rajat, Delgado-Mederos, Raquel, Prats-Sánchez, Luis, Camps-Renom, Pol, Blay, Natalia, Sumoy, Lauro, Martí-Fàbregas, Joan, Schnohr, Peter, Jensen, Gorm B, Benn, Marianne, Afzal, Shoaib, Kamstrup, Pia R, van Setten, Jessica, van der Laan, Sander W, Vonk, Jet M J, Kim, Bong-Jo, Curtze, Sami, Tiainen, Marjaana, Kinnunen, Janne, Menon, Vilas, Sung, Yun Ju, Yang, Chengran, Saillour-Glenisson, Florence, Gravel, Simon, Onland-Moret, N Charlotte, and Heath, Alicia K
- Subjects
Stroke ,Multidisciplinary ,Genetic markers ,ddc:500 ,Predictive markers ,Genome-wide association studies - Published
- 2022
120. Determinants of metabolic syndrome and its prognostic implications among stroke patients in Africa: Findings from the Stroke Investigative Research and Educational Network (SIREN) study.
- Author
-
Adeoye, Abiodun M., Akintunde, Adeseye A., Akinyemi, Joshua, Fakunle, Adekunle G., Sarfo, Fred S., Akpalu, Albert, Wahab, Kolawole, Obiako, Reginald, Komolafe, Morenikeji, Owolabi, Lukman, Osaigbovo, Godwin O., Akpa, Onoja, Arulogun, Oyedunni, Okekunle, Akinkunmi P., Ogah, Okechukwu S., Jenkins, Carolyn, Ogbole, Godwin, Tiwari, Hemant K., Asowata, Osahon J., and Ibinaiye, Philip
- Subjects
- *
PROGNOSIS , *METABOLIC syndrome , *STROKE patients , *AFRICANS , *EDUCATION research , *STROKE - Abstract
The prognostic implications of metabolic syndrome (METS) among African stroke patients are poorly understood. This study aimed to investigate the determinants of METS and its prognostic implications among Africans with newly diagnosed stroke in the SIREN study. We included stroke cases (adults aged >18 years with CT/MRI confirmed stroke). The validated tools comprehensively evaluated vascular, lifestyle, and psychosocial factors. We used logistic regression to estimate adjusted odds ratios (OR) with 95% CIs for the association between METS and risk factors. We also computed the prediction power of the domain of covariates in a sequential manner using the area under the receiver operating curve (ROC) curve. Among 3998 stroke subjects enrolled in the study, 76.8% had METS by at least one of the clinical definitions. Factors associated with METS were age > 50 years (OR- 1.46, CI-1.19-1.80), male gender (OR 4.06, CI- 3.28-5.03), income >100USD (OR1.42, CI-1.17-1.71), stress (OR1.46, CI-1.14-1.87), family history of diabetes mellitus (OR1.38, CI-1.06-1.78), and cardiac disease (OR1.42, CI-1.18-1.65). Stroke severity was higher among those with METS (SLS = 5.8 ± 4.3) compared with those without METS (6.2 ± 4.5) at p = 0.037. METS was associated with higher odds (aOR 1.31, CI-1.08-1.58) of one-month fatality after adjusting for stroke severity, age > 50 years, and average monthly income >100USD. METS is very common among African stroke patients and is associated with stroke severity and worse one-month fatality. Lifestyle interventions may prevent METS and attenuate its impact on stroke occurrence and outcomes. • Whether Metabolic Syndrome (METS) is associated with stroke among Africans is poorly understood. • Using IDF criteria, eight of ten patients with acute stroke had METS, and a third by the ATP III criteria. • METS was associated with stroke severity and one-month fatality in stroke survivors. • The findings have implications for early risk stratification of patients for prompt management and best post-stroke outcome. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
121. Frequency & factors associated with recurrent stroke in Ghana and Nigeria.
- Author
-
Akpalu, Albert, Sarfo, Fred S., Akinyemi, Joshua, Wahab, Kolawole, Komolafe, Morenikeji, Obiako, Reginald, Owolabi, Lukman, Osaigbovo, Godwin O., Ogbole, Godwin, Adebayo, Philip, Onoja, Akpa, Fakunle, Adekunle, Balogun, Olayemi, Fawale, Bimbo, Ogah, Okechukwu, Akinyemi, Rufus, Owolabi, Mayowa, and Ovbiagele, Bruce
- Subjects
- *
DYSLIPIDEMIA , *DISEASE risk factors , *FAMILY history (Medicine) , *SALT , *LOGISTIC regression analysis , *ODDS ratio - Abstract
Data on the burden and outcomes of recurrent strokes in sub-Saharan Africa are limited, impeding efforts at optimal recurrent stroke prevention. To assess the prevalence, risk factor profile, stroke types and mortality from recurrent strokes in Ghana and Nigeria. We analyzed data from 3553 stroke cases involved in the Stroke Investigative Research and Educational Networks (SIREN) study for proportion with recurrent strokes. Conditional logistic regression models were constructed to interrogate for risk factors of recurrent stroke compared with stroke-free controls. Generalized Linear models were used to assess correlates of recurrent strokes relative to index strokes. Among stroke cases, 335 (9.4%) were recurrent strokes, of which 79.9% were ischemic and 20.1% hemorrhagic. Those with recurrent stroke were significantly older than index stroke cases 62.2 ± 12.9 years vs 58.9 ± 14.0 years, p < 0.01 respectively. Topmost risk factors associated with recurrent stroke were hypertension adjusted odds ratio 50.7 (95%CI: 6.6–392.7), dyslipidemia 2.8 (1.3–6.2), diabetes mellitus 4.0 (2.1–7.7) and family history of cardiovascular disease (CVD) 2.1 (1.1–4.2). The relative risk (95%CI) of factors associated with recurrent stroke vs index stroke were age > 50 years (1.5: 1.1–2.0); Hausa ethnicity (1.5:1.1–2.1), Yoruba ethnicity with Akan as referent; table added salt (0.4:0.2–0.8) and current alcohol intake (0.6:0.4–0.9). In-patient mortality among those with recurrent stroke vs. primary stroke was 20.5% vs. 21.4%. Several modifiable lifestyle related factors may warrant additional emphasis as targets for reducing the burden of recurrent stroke in sub-Saharan Africa. • Data on recurrent strokes in Africa are scarce. • Of 3,553 stroke admissions in Ghana and Nigeria, 9.4% had recurrent strokes. • 80% of recurrent strokes are ischemic & 20% are ICH. • Hypertension, dyslipidemia, diabetes mellitus, & family history of CVD associated with recurrent strokes. • Mortality from recurrent stroke is 20.5%. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
122. Influence of age on links between major modifiable risk factors and stroke occurrence in West Africa.
- Author
-
Sarfo, Fred S., Akpa, Onoja, Ovbiagele, Bruce, Akpalu, Albert, Wahab, Kolawole, Komolafe, Morenikeji, Obiako, Reginald, Owolabi, Lukman, Osaigbovo, Godwin O., Jenkins, Carolyn, Ogbole, Godwin, Fakunle, Adekunle, Tiwari, Hemant K., Arulogun, Oyedunni, Arnett, Donna K., Asowata, Osahon, Ogah, Okechukwu, Akinyemi, Rufus O., and Owolabi, Mayowa O.
- Subjects
- *
STROKE , *AGE groups , *ADULTS , *MIDDLE age , *SEDENTARY behavior , *PSYCHOSOCIAL factors - Abstract
Background The burden of stroke in Africa is high. Understanding how age associates with major modifiable stroke risk factors could inform tailored demographic stroke prevention strategies. Purpose To quantify the magnitude and direction of the effect sizes of key modifiable stroke risk factors according to three age groups: <50 years (young), 50–65 years (middle age) and > 65 years (elderly) in West Africa. Methods This was a case-control study involving 15 sites in Ghana and Nigeria. Cases included adults aged ≥18 years with CT/MRI scan-typed stroke. Controls were age-and gender-matched stroke-free adults. Detailed evaluations for vascular, lifestyle and psychosocial factors were performed. We estimated adjusted odds ratios (aOR) using conditional logistic regression and population attributable risk (PAR) with 95% Confidence Interval of vascular risk factors by age groups. Results Among 3553 stroke cases, 813 (22.9%) were young, 1441 (40.6%) were middle-aged and 1299 (36.6%) were elderly. Among the 5 co-shared risk factors, dyslipidemia with PAR and aOR (95%CI) of 62.20% (52.82–71.58) and 4.13 (2.64–6.46) was highest among the young age group; hypertension with PAR of 94.31% (91.82–96.80) and aOR of 28.93 (15.10–55.44) was highest among the middle-age group. Diabetes with PAR of 32.29%(27.52–37.05) and aOR of 3.49 (2.56–4.75); meat consumption with PAR of 42.34%(32.33–52.35) and aOR of 2.40 (1.76, 3.26); and non-consumption of green vegetables, PAR of 16.81%(12.02–21.60) and aOR of 2.23 (1.60–3.12) were highest among the elderly age group. However confidence intervals of risk estimates overlapped across age groups. Additionally, among the young age group cigarette smoking, psychosocial stress and cardiac disease were independently associated with stroke. Furthermore, education, stress, physical inactivity and salt intake were associated with stroke in the middle-age group while cardiac disease was associated with stroke in the elderly age group. Conclusion There is a differential influence of age on the associations of major risk factors with stroke in this West African cohort. Targeting modifiable factors predominant within an age group may be more effective as a stroke prevention strategy. • Evidence-based strategies are urgently needed to address the dominant vascular risk factors in Africa. • 25% of strokes occur in the young, 40% occur in middle ages and 35% occur in the elderly. • Hypertension, dyslipidemia, diabetes, regular meat and low vegetable consumption are co-shared factors for stroke. • Targeting modifiable factors predominant by age groups may be a viable stroke prevention strategy. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
123. Frequency and factors associated with post-stroke seizures in a large multicenter study in West Africa.
- Author
-
Sarfo, Fred S., Akinyemi, Joshua, Akpalu, Albert, Wahab, Kolawole, Yaria, Joseph, Adebayo, Oladimeji, Komolafe, Morenike, Obiako, Reginald, Owolabi, Lukman, Osaigbovo, Godwin O., Jenkins, Carolyn, Mensah, Yaw, Ogbole, Godwin, Calys-Tagoe, Benedict, Adebayo, Philip, Appiah, Lambert, Singh, Arti, Fakunle, Adekunle, Uvere, Ezinne, and Hemant, Tiwari
- Subjects
- *
ISCHEMIC stroke , *HEMORRHAGIC stroke , *STROKE , *SEIZURES (Medicine) , *LEUCOCYTES , *ADULTS - Abstract
Post-stroke seizures (PSS) are associated with significant morbidity and mortality across the globe. There is a paucity of data on PSS in Africa. To assess the frequency and factors associated with PSS by stroke types across 15 hospitals in Nigeria and Ghana. We analyzed data on all stroke cases recruited into the Stroke Investigative Research and Educational Network (SIREN). We included adults aged ≥18 years with radiologically confirmed ischemic stroke (IS) or intracerebral hemorrhage (ICH). PSS were defined as acute symptomatic seizures occurring at stroke onset and/or during acute hospitalization up until discharge. We used logistic regression to estimate adjusted odds ratios (aOR) with 95% Confidence Interval. Among 3344 stroke patients, 499 (14.9%) had PSS (95% CI: 13.7–16.2%). The mean duration of admission in days for those with PSS vs no PSS was 17.4 ± 28.6 vs 15.9 ± 24.7, p = 0.72. There were 294(14.1%) PSS among 2091 ischemic strokes and 159(17.7%) among 897 with ICH, p = 0.01. The factors associated with PSS occurrence were age < 50 years, aOR of 1.59 (1.08–2.33), National Institute of Health Stroke Score (NIHSS), 1.29 (1.16–1.42) for each 5 units rise and white cell count 1.07 (1.01–1.13) for each 10^3 mm3 rise. Factors associated with PSS in ischemic were NIHSS score, aOR of 1.17 (1.04–1.31) and infarct volume of 10–30 cm3 aOR of 2.17(1.37–3.45). Among ICH, associated factors were alcohol use 5.91 (2.11–16.55) and lobar bleeds 2.22 (1.03–4.82). The burden of PSS among this sample of west Africans is substantial and may contribute to poor outcomes of stroke in this region. Further longitudinal studies are required to understand the impact on morbidity and mortality arising from PSS in Africa. • There is paucity of data on post stroke seizures (PSS) from multicenter studies in Africa. • Across 15 sites in Ghana and Nigeria, the frequency of PSS was 15%. • The frequency of PSS in hemorrhagic stroke was 18% vs 14% in ischemic strokes. • Age < 50 years, severe strokes and elevated leucocyte counts were associated with occurrence of PSS. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
124. Antecedent febrile illness and occurrence of stroke in West Africa: The SIREN study.
- Author
-
Sarfo, Fred Stephen, Ovbiagele, Bruce, Matthew, Onoja Akpa, Akpalu, Albert, Wahab, Kolawole, Obiako, Reginald, Owolabi, Lukman, Asowata, Osahon, Ogbole, Godwin, Komolafe, Morenikeji, Akinyemi, Rufus, and Owolabi, Mayowa
- Subjects
- *
CARDIOVASCULAR diseases , *DISEASES , *PSYCHOSOCIAL factors , *LOGISTIC regression analysis , *ODDS ratio - Abstract
Acute infections have been posited as potential precipitants or triggers of the occurrence of stroke among adults with traditional vascular risk factors. We evaluated associations between stroke occurrence and reported febrile illness within 4 weeks (potential antecedent infections) among West Africans. The Stroke Investigative Research and Educational Network (SIREN) is a multicenter, case-control study involving 15 sites in Ghana and Nigeria. Cases include adults aged ≥18 years with radiologically confirmed strokes. Controls were stroke-free adults matched with cased by age, gender and ethnicity. Detailed evaluations for vascular, lifestyle and psychosocial factors were performed. Participants were asked for evidence of any febrile illness within the past 4 weeks. We used conditional logistic regression to estimate adjusted odds ratios (aOR) with 95% Confidence Interval. Among 3588 stroke cases recruited in Ghana and Nigeria between August 2014 and July 2018, 363 cases (10.1%) reported having a febrile illness within the 4 weeks prior to stroke occurrence. Having an antecedent infection was associated with stroke occurrence with an unadjusted OR of 1.19 (1.00–1.51) but aOR of 0.83 (0.59–1.17) upon adjusting for traditional vascular risk factors. Stress, aOR of 4.69 (2.59–8.50) and consumption of green vegetables 2.27 (1.35–2.85) were associated with antecedent febrile illness. 1 in 10 stroke cases reported antecedent history of febrile illness prior to occurrence of stroke but no independent association was observed in this study. Infectious exposures may be important triggers of cardiovascular events requiring further exploratory studies to better understand the role of this emerging risk factor. • 1 in 10 stroke cases are preceded by a febrile illness in West Africa. • Stress is associated with antecedent febrile illness before stroke. • Antecedent febrile illness not independently associated with stroke. • Infections could be important triggers of stroke in Africa. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
125. Non-cigarette Tobacco Use and Stroke Among West Africans: Evidence From the SIREN Study.
- Author
-
Fakunle AG, Okekunle AP, Asowata OJ, Akpa O, Sarfo FS, Akpalu A, Wahab K, Obiako R, Komolafe M, Owolabi L, Osaigbovo GO, Adeoye AM, Tiwari HK, Uvere EO, Akinyemi J, Jenkins C, Arulogun O, Ibinaiye P, Appiah LT, Bello T, Singh A, Yaria J, Calys-Tagoe B, Ogbole G, Chukwuonye I, Melikam C, Adebayo P, Mensah Y, Adebayo O, Adeniyi S, Oguike W, Donna A, Akinyemi R, Ovbiagele B, and Owolabi M
- Subjects
- Humans, Female, Male, Middle Aged, Adult, Tobacco, Smokeless statistics & numerical data, Aged, Africa, Western epidemiology, Africa, Western ethnology, Black People statistics & numerical data, West African People, Stroke epidemiology, Tobacco Use epidemiology
- Abstract
Introduction: Non-cigarette tobacco (NCT) represents a form of tobacco use with a misperceived significance in chronic disease events. Whether NCT use is sufficient to promote stroke events, especially among Africans, is yet to be understood. This study assessed the relationship between NCT use and stroke among indigenous Africans., Methods: A total of 7617 respondents (NCT users: 41 vs. non-NCT: 7576) from the Stroke Investigative Research and Educational Network (SIREN) study were included in the current analysis. NCT use was defined as self-reported use of smoked (cigars or piper) or smokeless (snuff or chewed) tobacco in the past year preceding stroke events. Stroke was defined based on clinical presentation and confirmed with a cranial computed tomography/magnetic resonance imaging. Multivariable-adjusted logistic regression was applied to estimate the odds ratio (OR) and 95% confidence interval (CI) for the relationship of NCT with stroke at a two-sided p < .05., Results: Out of the 41 (0.54%) who reported NCT use, 27 (65.9%) reported using smokeless NCT. NCT users were older than non-NCT users (62.8 ± 15.7 vs. 57.7 ± 14.8 years). Overall, NCT use was associated with first-ever stroke (OR: 2.08; 95% CI: 1.02, 4.23) in the entire sample. Notably, smokeless NCT use was independently associated with higher odds of stroke (OR: 2.74; 95% CI: 1.15, 6.54), but smoked NCT use (OR: 0.16; 95% CI: 0.02, 1.63) presented a statistically insignificant association after adjusting for hypertension and other covariates., Conclusions: NCT use was associated with higher odds of stroke, and public health interventions targeting NCT use might be promising in reducing the burden of stroke among indigenous Africans., Implications: A detailed understanding of the relationship between NCT use and stroke will likely inform well-articulated policy guidance and evidence-based recommendations for public health prevention and management of stroke on the African continent., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2024
- Full Text
- View/download PDF
126. Stroke occurrence by hypertension treatment status in Ghana and Nigeria: A case-control study.
- Author
-
Sarfo FS, Asowata OJ, Akpa OM, Akinyemi J, Wahab K, Singh A, Akpalu A, Opare-Addo PA, Okekunle AP, Ogbole G, Fakunle A, Adebayo O, Obiako R, Akisanya C, Komolafe M, Olunuga T, Chukwuonye II, Osaigbovo G, Olowoyo P, Adebayo PB, Jenkins C, Bello A, Laryea R, Ibinaye P, Olalusi O, Adeniyi S, Arulogun O, Ogah O, Adeoye A, Samuel D, Calys-Tagoe B, Tiwari H, Obiageli O, Mensah Y, Appiah L, Akinyemi R, Ovbiagele B, and Owolabi M
- Subjects
- Humans, Ghana epidemiology, Nigeria epidemiology, Case-Control Studies, Risk Factors, Stroke epidemiology, Stroke therapy, Stroke etiology, Hypertension epidemiology, Hypertension complications
- Abstract
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.)
- Published
- 2024
- Full Text
- View/download PDF
127. ACHIEVE conference proceedings: implementing action plans to reduce and control hypertension burden in Africa.
- Author
-
Olowoyo P, Dzudie A, Okekunle AP, Obiako R, Mocumbi A, Beheiry H, Parati G, Lackland DT, Sarfo FS, Odili A, Adeoye AM, Wahab K, Agyemang C, Campbell N, Kengne AP, Whelton PK, Pellicori P, Ebenezer AA, Adebayo O, Olalusi O, Jegede A, Uvere E, Adebajo O, Awuah B, Moran A, Williams B, Guzik TJ, Kokuro C, Bukachi F, Ogah OS, Delles C, Maffia P, Akinyemi R, Barango P, Ojji D, and Owolabi M
- Subjects
- Humans, Africa epidemiology, Prevalence, Hypertension diagnosis, Hypertension epidemiology, Hypertension prevention & control
- Abstract
The prevalence of hypertension, the commonest risk factor for preventable disability and premature deaths, is rapidly increasing in Africa. The African Control of Hypertension through Innovative Epidemiology, and a Vibrant Ecosystem [ACHIEVE] conference was convened to discuss and initiate the co-implementation of the strategic solutions to tame this burden toward achieving a target of 80% for awareness, treatment, and control by the year 2030. Experts, including the academia, policymakers, patients, the WHO, and representatives of various hypertension and cardiology societies generated a 12-item communique for implementation by the stakeholders of the ACHIEVE ecosystem at the continental, national, sub-national, and local (primary) healthcare levels., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)
- Published
- 2024
- Full Text
- View/download PDF
128. Novel functional insights into ischemic stroke biology provided by the first genome-wide association study of stroke in indigenous Africans.
- Author
-
Akinyemi RO, Tiwari HK, Srinivasasainagendra V, Akpa O, Sarfo FS, Akpalu A, Wahab K, Obiako R, Komolafe M, Owolabi L, Osaigbovo GO, Mamaeva OA, Halloran BA, Akinyemi J, Lackland D, Obiabo OY, Sunmonu T, Chukwuonye II, Arulogun O, Jenkins C, Adeoye A, Agunloye A, Ogah OS, Ogbole G, Fakunle A, Uvere E, Coker MM, Okekunle A, Asowata O, Diala S, Ogunronbi M, Adeleye O, Laryea R, Tagge R, Adeniyi S, Adusei N, Oguike W, Olowoyo P, Adebajo O, Olalere A, Oladele O, Yaria J, Fawale B, Ibinaye P, Oyinloye O, Mensah Y, Oladimeji O, Akpalu J, Calys-Tagoe B, Dambatta HA, Ogunniyi A, Kalaria R, Arnett D, Rotimi C, Ovbiagele B, and Owolabi MO
- Subjects
- Adult, Humans, Genome-Wide Association Study, Genetic Predisposition to Disease, Genomics, Polymorphism, Single Nucleotide, DNA, Multicenter Studies as Topic, Ischemic Stroke complications, Stroke genetics, MicroRNAs
- Abstract
Background: African ancestry populations have the highest burden of stroke worldwide, yet the genetic basis of stroke in these populations is obscure. The Stroke Investigative Research and Educational Network (SIREN) is a multicenter study involving 16 sites in West Africa. We conducted the first-ever genome-wide association study (GWAS) of stroke in indigenous Africans., Methods: Cases were consecutively recruited consenting adults (aged > 18 years) with neuroimaging-confirmed ischemic stroke. Stroke-free controls were ascertained using a locally validated Questionnaire for Verifying Stroke-Free Status. DNA genotyping with the H3Africa array was performed, and following initial quality control, GWAS datasets were imputed into the NIH Trans-Omics for Precision Medicine (TOPMed) release2 from BioData Catalyst. Furthermore, we performed fine-mapping, trans-ethnic meta-analysis, and in silico functional characterization to identify likely causal variants with a functional interpretation., Results: We observed genome-wide significant (P-value < 5.0E-8) SNPs associations near AADACL2 and miRNA (MIR5186) genes in chromosome 3 after adjusting for hypertension, diabetes, dyslipidemia, and cardiac status in the base model as covariates. SNPs near the miRNA (MIR4458) gene in chromosome 5 were also associated with stroke (P-value < 1.0E-6). The putative genes near AADACL2, MIR5186, and MIR4458 genes were protective and novel. SNPs associations with stroke in chromosome 2 were more than 77 kb from the closest gene LINC01854 and SNPs in chromosome 7 were more than 116 kb to the closest gene LINC01446 (P-value < 1.0E-6). In addition, we observed SNPs in genes STXBP5-AS1 (chromosome 6), GALTN9 (chromosome 12), FANCA (chromosome 16), and DLGAP1 (chromosome 18) (P-value < 1.0E-6). Both genomic regions near genes AADACL2 and MIR4458 remained significant following fine mapping., Conclusions: Our findings identify potential roles of regulatory miRNA, intergenic non-coding DNA, and intronic non-coding RNA in the biology of ischemic stroke. These findings reveal new molecular targets that promise to help close the current gaps in accurate African ancestry-based genetic stroke's risk prediction and development of new targeted interventions to prevent or treat stroke., (© 2024. The Author(s).)
- Published
- 2024
- Full Text
- View/download PDF
129. Clinical and neuroimaging factors associated with 30-day fatality among indigenous West Africans with spontaneous intracerebral hemorrhage.
- Author
-
Komolafe MA, Sunmonu T, Akinyemi J, Sarfo FS, Akpalu A, Wahab K, Obiako R, Owolabi L, Osaigbovo GO, Ogbole G, Tiwari HK, Jenkins C, Lackland DT, Fakunle AG, Uvere E, Akpa O, Dambatta HA, Akpalu J, Onasanya A, Olaleye A, Ogah OS, Isah SY, Fawale MB, Adebowale A, Okekunle AP, Arnett D, Adeoye AM, Agunloye AM, Bello AH, Aderibigbe AS, Idowu AO, Sanusi AA, Ogunmodede A, Balogun SA, Egberongbe AA, Rotimi FT, Fredrick A, Akinnuoye AO, Adeniyi FA, Calys-Tagoe B, Adebayo P, Arulogun O, Agbogu-Ike OU, Yaria J, Appiah L, Ibinaiye P, Singh A, Adeniyi S, Olalusi O, Mande A, Balogun O, Akinyemi R, Ovbiagele B, and Owolabi M
- Subjects
- Male, Adult, Humans, Adolescent, Middle Aged, Female, Case-Control Studies, Risk Factors, Ghana epidemiology, Neuroimaging, Cerebral Hemorrhage diagnostic imaging, Stroke diagnostic imaging
- Abstract
Background: Spontaneous intracerebral hemorrhage (ICH) is associated with a high case fatality rate in resource-limited settings. The independent predictors of poor outcome after ICH in sub-Saharan Africa remains to be characterized in large epidemiological studies. We aimed to determine factors associated with 30-day fatality among West African patients with ICH., Methods: The Stroke Investigative Research and Educational Network (SIREN) study is a multicentre, case-control study conducted at 15 sites in Nigeria and Ghana. Adults aged ≥18 years with spontaneous ICH confirmed with neuroimaging. Demographic, cardiovascular risk factors, clinical features and neuroimaging markers of severity were assessed. The independent risk factors for 30-day mortality were determined using a multivariate logistic regression analysis with an adjusted odds ratio (OR) and 95% confidence interval (CI)., Results: Among 964 patients with ICH, 590 (61.2%) were males with a mean age (SD) of 54.3(13.6) years and a case fatality of 34.3%. Factors associated with 30-day mortality among ICH patients include: Elevated mean National Institute of Health Stroke Scale(mNIHSS);(OR 1.06; 95% CI 1.02-1.11), aspiration pneumonitis; (OR 7.17; 95% CI 2.82-18.24), ICH volume > 30mls; OR 2.68; 95% CI 1.02-7.00)) low consumption of leafy vegetables (OR 0.36; 95% CI 0.15-0.85)., Conclusion: This study identified risk and protective factors associated with 30-day mortality among West Africans with spontaneous ICH. These factors should be further investigated in other populations in Africa to enable the development of ICH mortality predictions models among indigenous Africans., Competing Interests: Declaration of Competing Interest The authors declare that there are no conflicts of interests with the article. The article was written according to recommendation from International Committee of Medical Journals Editors., (Copyright © 2023 Elsevier B.V. All rights reserved.)
- Published
- 2024
- Full Text
- View/download PDF
130. Research participants' perception of ethical issues in stroke genomics and neurobiobanking research in Africa.
- Author
-
Jegede A, Balogun O, Olorunsogbon OF, Nichols M, Akinyemi J, Jenkins C, Ogunronbi M, Singh A, Obiako R, Wahab K, Bello A, Akpalu A, Sarfo FS, Owolabi LF, Ojebuyi B, Adigun M, Olujobi D, Musbahu R, Titiloye M, Afolami I, Calys-Tagoe B, Uvere E, Laryea R, Fakunle A, Adeleye O, Adesina D, Mensah N, Oguike W, Coleman N, Adeniyi S, Omotoso L, Asibey S, Melikam L, Yusuf J, Gbenga A, Mande A, Uthman M, Kalaria RN, Owolabi M, Ovbiagele B, Arulogun O, and Akinyemi RO
- Abstract
Background: There is a growing interest in stroke genomics and neurobiobanking research in Africa. These raise several ethical issues, such as consent, re-use, data sharing, storage, and incidental result of biological samples. Despite the availability of ethical guidelines developed for research in Africa, there is paucity of information on how the research participants' perspectives could guide the research community on ethical issues in stroke genomics and neurobiobanking research. To explore African research participants' perspectives on these issues, a study was conducted at existing Stroke Investigation Research and Education Network (SIREN) sites in Nigeria and Ghana., Method: Using an exploratory design, twenty-eight Focus Group Discussions (FGDs) sessions were conducted with stroke survivors (n=7), caregivers(n=7), stroke - free controls(n=7), and Community Advisory Board members(n=7). Data were collected using an interview guide. Interviews were conducted in English and indigenous languages of the community, audio recorded, and transcribed verbatim. Data were analyzed using NVivo (March, 2020) Software., Result: Results revealed that stroke genomics and neurobiobanking research in Africa require researchers' direct attention to ethical issues. Concerns were raised about understanding, disclosure and absence of coercion as components of true autonomous decision making in research participation. Participants argued that the risk and benefits attached to participation should be disclosed at the time of recruitment. Fears around data sharing were voiced as adherence to the principle of privacy and confidentiality were of paramount importance to participants. The preference was to receive the results of incidental findings with no stigma attached from society., Conclusion: Research participants' perspectives are a vital aspect of community engagement in stroke genomics and neurobiobanking research. Findings from this study suggest that research participants are interested in these fields of research in Africa if their concerns about ethical issues are appropriately addressed within the research framework., Competing Interests: Disclosure of interest The authors report there are no competing interests to declare.
- Published
- 2023
- Full Text
- View/download PDF
131. Knowledge and perspectives of community members on risk assessment for stroke prevention using mobile health approaches in Nigeria.
- Author
-
Sarfo FS, Obiako R, Nichols M, Akinyemi JO, Fakunle A, Akpa O, Arulogun O, Akinyemi R, Jenkins C, Ovbiagele B, and Owolabi M
- Subjects
- Adult, Female, Humans, Middle Aged, Adolescent, Male, Cross-Sectional Studies, Nigeria epidemiology, Risk Assessment, Telemedicine, Stroke diagnosis, Stroke epidemiology, Stroke prevention & control
- Abstract
Objectives: To assess the knowledge of community dwelling adults on stroke risk and their willingness to use mobile health (mHealth) technology in assessing their stroke risk., Materials and Methods: A cross-sectional study was conducted among adults (≥18 years old) using survey questionnaires designed by neurologists and health promotion experts and administered by trained study staff. Logistic regression models were used to assess factors associated with receptivity toward knowing individual stroke risk score and willingness to use a mobile application (App) to assess stroke risk., Results: The survey was administered to 486 participants in Nigeria, with a mean age of 47.4 ± 15.5 years, comprising 53.5% females. Up to 84% of participants wanted to know their risk for developing stroke but only 29.6% of respondents had ever previously had their stroke risk assessed. Factors associated with willingness to know stroke risk were age [aOR (95% CI): 0.97 (0.95 - 0.99)], and Hausa tribe [16.68 (2.16 - 128.92)]. Up to 66% of participants wanted to know their immediate risk of stroke, compared with 6.6% and 2.1% who wanted to know their 5-year or 10-year future stroke risks respectively. Regarding locations, participants preferred stroke risk assessment to be performed at a health facility, at home by health professional, on their own using mHealth (stroke risk calculator application), or at communal gatherings (decreasing order). About 70% specifically wished to learn about their stroke risk via an mHealth application., Conclusions: Community dwelling Nigerians wanted to know their immediate risk of stroke using digital platforms, such as a mobile phone stroke risk calculator application. Clinical trials are needed to assess the effectiveness of such a strategy for primary prevention of stroke in sub-Saharan African communities., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2023 Elsevier Inc. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
132. Determinants of First-Ever Stroke Severity in West Africans: Evidence From the SIREN Study.
- Author
-
Adebayo O, Akpa O, Asowata OJ, Fakunle A, Sarfo FS, Akpalu A, Wahab K, Obiako R, Komolafe M, Owolabi L, Osaigbovo GO, Okekunle AP, Sunmonu T, Tiwari HK, Jenkins C, Arulogun O, Appiah L, Akinyemi J, Adeoye AM, Ogbole G, Yaria J, Arnett D, Adebayo P, Calys-Tagoe B, Ogah OS, Balogun O, Ogunjimi L, Mensah Y, Agbogu-Ike OU, Akinyemi R, Ovbiagele B, and Owolabi MO
- Subjects
- Humans, African People, Brain, Cerebral Hemorrhage diagnostic imaging, Cerebral Hemorrhage epidemiology, Infarction, Risk Factors, Stroke epidemiology, Ischemic Stroke
- Abstract
Background Baseline stroke severity is probably partly responsible for poor stroke outcomes in sub-Saharan Africa. However, there is a paucity of information on determinants of stroke severity among indigenous Africans. We sought to identify the factors associated with stroke severity among West Africans in the SIREN (Stroke Investigative Research and Educational Networks) study. Methods and Results Stroke was diagnosed clinically and confirmed with brain neuroimaging. Severe stroke was defined as a Stroke Levity Scale score of ≤5. A multivariate logistic regression model was constructed to identify factors associated with stroke severity at 95% CI and a nominal cutoff of 5% type 1 error. A total of 3660 stroke cases were included. Overall, 50.7%% had severe stroke, including 47.6% of all ischemic strokes and 56.1% of intracerebral hemorrhage. Factors independently associated with severe stroke were meat consumption (adjusted odds ratio [aOR], 1.97 [95% CI, 1.43-2.73]), low vegetable consumption (aOR, 2.45 [95% CI, 1.93-3.12]), and lesion volume, with an aOR of 1.67 (95% CI, 1.03-2.72) for lesion volume of 10 to 30 cm
3 and aOR of 3.88 (95% CI, 1.93-7.81) for lesion volume >30 cm3 . Severe ischemic stroke was independently associated with total anterior circulation infarction (aOR, 3.1 [95% CI, 1.5-6.9]), posterior circulation infarction (aOR, 2.2 [95% CI, 1.1-4.2]), and partial anterior circulation infarction (aOR, 2.0 [95% CI, 1.2-3.3]) compared with lacunar stroke. Increasing age (aOR, 2.6 [95% CI, 1.3-5.2]) and lesion volume >30 cm3 (aOR, 6.2 [95% CI, 2.0-19.3]) were independently associated with severe intracerebral hemorrhage. Conclusions Severe stroke is common among indigenous West Africans, where modifiable dietary factors are independently associated with it. These factors could be targeted to reduce the burden of severe stroke.- Published
- 2023
- Full Text
- View/download PDF
133. Effect of an Educational Intervention for Primary Stroke Risk Reduction in Ghana and Nigeria: Pilot Randomized Controlled Trial.
- Author
-
Sarfo FS, Akinyemi JO, Obiako R, Nichols M, Fakunle AG, Adusei N, Ampofo M, Arulogun O, Jenkins C, Akpa OM, Aribisala B, Abdulrasaq S, Akinyemi R, Ovbiagele B, and Owolabi MO
- Subjects
- Male, Adult, Humans, Middle Aged, Aged, Female, Pilot Projects, Ghana epidemiology, Nigeria epidemiology, Risk Reduction Behavior, Stroke epidemiology, Stroke prevention & control, Stroke complications
- Abstract
Background: Using tailored mobile health interventions to improve global vascular risk awareness and control is yet to be investigated for primary stroke prevention in Africa., Methods: This 2-arm pilot randomized controlled trial involved 100 stroke-free adults with at least 2 vascular risk factors for stroke. Eligible participants were assigned randomly to a control arm offering 1-time counseling (n=50) or a 2-month educational intervention arm (n=50) comprising a stroke video and riskometer app aimed at improving stroke risk factor awareness and health-seeking behavioral modification to control total vascular risk. Reduction in total stroke risk score was the primary outcome while feasibility and process measures were secondary outcomes., Results: All enrolled participants completed the 2-month follow-up (retention rate=100%). The mean (SD) age of participants was 59.5 (±12.5) years, 38% were males. The mean change in stroke risk score at 2 months was -11.9% (±14.2) in the intervention arm versus -1.2% (±9.1) in the control arm, P =0.0001. Stroke risk awareness improved by 16.1% (±24.7) in the intervention arm versus 8.9% (±24.7) in the control arm, P =0.08. The intervention arm had 11.1 mm Hg reduction in systolic blood pressure compared with 4.8 mm Hg reduction in the control arm., Conclusions: The intervention demonstrated a positive signal of effect over a 2-month period. A definitive clinical trial with a longer duration of follow-up is warranted on the premise of these promising findings from this pilot randomized clinical trial., Registration: URL: https://www., Clinicaltrials: gov; Unique identifier: NCT05619406., Competing Interests: Disclosures None.
- Published
- 2023
- Full Text
- View/download PDF
134. Patient-level and system-level determinants of stroke fatality across 16 large hospitals in Ghana and Nigeria: a prospective cohort study.
- Author
-
Sarfo FS, Akpa OM, Ovbiagele B, Akpalu A, Wahab K, Obiako R, Komolafe M, Owolabi L, Ogbole G, Fakunle A, Okekunle AP, Asowata OJ, Calys-Tagoe B, Uvere EO, Sanni T, Olowookere S, Ibinaiye P, Akinyemi JO, Arulogun O, Jenkins C, Lackland DT, Tiwari HK, Isah SY, Abubakar SA, Oladimeji A, Adebayo P, Akpalu J, Onyeonoro U, Ogunmodede JA, Akisanya C, Mensah Y, Oyinloye OI, Appiah L, Agunloye AM, Osaigbovo GO, Adeoye AM, Adeleye OO, Laryea RY, Olunuga T, Ogah OS, Oguike W, Ogunronbi M, Adeniyi W, Olugbo OY, Bello AH, Ogunjimi L, Diala S, Dambatta HA, Singh A, Adamu S, Obese V, Adusei N, Owusu D, Ampofo M, Tagge R, Fawale B, Yaria J, Akinyemi RO, and Owolabi MO
- Subjects
- Adult, Humans, Adolescent, Prospective Studies, Nigeria epidemiology, Ghana epidemiology, Hospitals, Stroke, Brain Ischemia, Pneumonia, Aspiration complications
- Abstract
Background: Every minute, six indigenous Africans develop new strokes. Patient-level and system-level contributors to early stroke fatality in this region are yet to be delineated. We aimed to identify and quantify the contributions of patient-level and system-level determinants of inpatient stroke fatality across 16 hospitals in Ghana and Nigeria., Methods: The Stroke Investigative Research and Educational Network (SIREN) is a multicentre study involving 16 sites in Ghana and Nigeria. Cases include adults (aged ≥18 years) with clinical and radiological evidence of an acute stroke. Data on stroke services and resources available at each study site were collected and analysed as system-level factors. A host of demographic and clinical variables of cases were analysed as patient-level factors. A mixed effect log-binomial model including both patient-level and system-level covariates was fitted. Results are presented as adjusted risk ratios (aRRs) with respective 95% CIs., Findings: Overall, 814 (21·8%) of the 3739 patients admitted with stroke died as inpatients: 476 (18·1%) of 2635 with ischaemic stroke and 338 (30·6%) of 1104 with intracerebral haemorrhage. The variability in the odds of stroke fatality that could be attributed to the system-level factors across study sites assessed using model intracluster correlation coefficient was substantial at 7·3% (above a 5% threshold). Stroke units were available at only five of 16 centres. The aRRs of six patient-level factors associated with stroke fatality were: low vegetable consumption, 1·19 (95% CI 1·07-1·33); systolic blood pressure, 1·02 (1·01-1·04) for each 10 mm Hg rise; stroke lesion volume more than 30 cm
3 , 1·48 (1·22-1·79); National Institutes of Health Stroke Scale (NIHSS) score, 1·20 (1·13-1·26) for each 5-unit rise; elevated intracranial pressure, 1·75 (1·31-2·33); and aspiration pneumonia, 1·79 (1·16-2·77)., Interpretation: Studies are needed to assess the efficacy of interventions targeting patient-level factors such as aspiration pneumonia in reducing acute stroke fatality in this region. Policy directives to improve stroke unit access are warranted., Funding: US National Institutes of Health., Translations: For the Twi, Yoruba and Hausa translations of the abstract see Supplementary Materials section., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.)- Published
- 2023
- Full Text
- View/download PDF
135. Are there differences in perceptions, preferences and attitudes towards disclosure of genetic testing for Stroke? A qualitative study among stroke-free SIREN-SIBS genomics study participants.
- Author
-
Arulogun O, Nichols M, Jenkins C, Fakunle AG, Akpa O, Sarfo FS, Akpalu A, Wahab K, Obiako R, Komolafe M, Owolabi L, Osaigbovo GO, Okekunle AP, Akinyemi J, Ogbole G, Calys-Tagoe B, Adeleye A, Mensah Y, Asowata OJ, Adeoye AM, Appiah L, Singh A, Adebayo P, Arnett D, Tiwari HK, Lackland D, Ibinaiye P, Oguike W, Melikam C, Sunday A, Bello A, Ogah O, Akinyemi R, Ovbiagele B, and Owolabi M
- Subjects
- Humans, Qualitative Research, Genetic Testing, Family, Disclosure, Health Personnel psychology
- Abstract
Objective: This study explored perceptions, preferences and attitudes towards disclosure of genetic testing results for stroke among stroke-free controls (and their family members) in the SIREN-SIBS Genomics Study, healthcare providers and policymakers., Materials and Methods: We conducted a qualitative thematic analysis of key informant interviews with 61 participants recruited from community advisory boards (30) and health care providers (31) across seven sites in Nigeria and Ghana., Results: Major findings illustrate differences in the knowledge of genetic testing with superior knowledge among health care professionals. Relatives and religious leaders were opined as the best to receive the disclosure as they would be able to break the news to the patient in a culturally sensitive manner to reduce the likely resultant emotional outburst. Poor level of awareness of national guidelines for disclosing genetic results exist. Key facilitating factors for disclosure are education, enabling environment, involvement of religious and community leaders, campaigns, and possible treatment options. Disclosure inhibitors include inadequate information, fear of marital break-up or family displacement, fear of stigmatization, fear of isolation, religious beliefs, health worker attitude, and lack of preparedness to accept results., Conclusions: These necessitate culturally sensitive interventions for continuing education, increased awareness and sustained engagement to equip all stakeholders in genetic testing disclosure process., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2023 Elsevier Inc. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
136. Differential associations between pre-diabetes, diabetes and stroke occurrence among West Africans.
- Author
-
Sarfo FS, Ovbiagele B, Akinyemi J, Akpa O, Akpalu A, Wahab K, Ogbole G, Obiako R, Komolafe M, Owolabi L, Osaigbovo G, Jenkins C, Fakunle A, Adeoye A, Lackland D, Arnett D, Tiwari HK, Olunuga T, Uvere E, Fawale B, Ogah O, Agunloye A, Faniyan M, Diala S, Yinka O, Laryea R, Osimhiarherhuo A, Akinsanya C, Abdulwasiu A, Akpalu J, Arulogun O, Appiah L, Dambatta H, Olayemi B, Onasanya A, Isah S, Akinyemi R, and Owolabi M
- Subjects
- Adult, Male, Humans, Adolescent, Middle Aged, Aged, Female, Glycated Hemoglobin, Case-Control Studies, Blood Glucose, Risk Factors, Prediabetic State diagnosis, Prediabetic State epidemiology, Stroke diagnosis, Stroke epidemiology, Diabetes Mellitus diagnosis, Diabetes Mellitus epidemiology, Ischemic Stroke
- Abstract
Background: There are limited data from Africa on the burden and associations between pre-diabetes (pre-DM), diabetes mellitus (DM) and stroke occurrence in a region experiencing a profound rise in stroke burden., Purpose: To characterize the associations between stroke and dysglycemic status among West Africans., Methods: The Stroke Investigative Research and Educational Network (SIREN) is a multicenter, case-control study involving 15 sites in Ghana and Nigeria. Cases include adults aged ≥18 years with clinical and radiological evidence of an acute stroke. Controls were age-and-gender matched stroke-free adults. Detailed evaluations for vascular factors were performed. Pre-diabetes was defined as HBA1c of 5.7%-6.4% or Fasting blood glucose (FBG) 5.6-7.0 mmol/L and DM as HBA1c >6.5% or FBG>7.0 mmol/L. We used conditional logistic regression to estimate adjusted odds ratios (aOR) with 95% Confidence Interval., Results: Among 2,935 stroke cases the mean age was 60.0 ± 14.2 years with 55.2% being males. By glycemic status, 931 (31.7%) were euglycemic, 633 (21.6%) had Pre-diabetes and 1371 (46.7%) had DM. Of the age- and sex-matched stroke-free controls 69.2% were euglycemic, 13.3% had pre-DM and 17.5% had DM. Pre-DM [aOR (95% CI): 3.68(2.61-5.21)] and DM [4.29 (3.19-5.74)] were independently associated with stroke. The aOR of Pre-DM for ischemic stroke 3.06 (2.01-4.64)] was lower than 4.82 (3.37-6.89) for DM. However, the aOR of Pre-DM for hemorrhagic stroke 6.81 (95% CI: 3.29 - 14.08)] was higher than 3.36 (1.94-5.86) for DM. Furthermore, the aOR of pre-DM for ischemic stroke subtypes were 9.64 (1.30-71.57) for cardio-embolic stroke, 3.64 (1.80-7.34) for small-vessel occlusive disease and 4.63 (0.80-26.65) for large-vessel disease., Conclusion: Pre-DM is strongly and independently associated with stroke in Africans. Improving glycemic control through screening, healthy lifestyle and pharmacotherapy at a population level may be strategic in reducing the rising burden of stroke in Africa., (Copyright © 2022. Published by Elsevier Inc.)
- Published
- 2022
- Full Text
- View/download PDF
137. A Novel Afrocentric Stroke Risk Assessment Score: Models from the Siren Study.
- Author
-
Akpa O, Sarfo FS, Owolabi M, Akpalu A, Wahab K, Obiako R, Komolafe M, Owolabi L, Osaigbovo GO, Ogbole G, Tiwari HK, Jenkins C, Fakunle AG, Olowookere S, Uvere EO, Akinyemi J, Arulogun O, Akpalu J, Tito-Ilori MM, Asowata OJ, Ibinaiye P, Akisanya C, Oyinloye OI, Appiah L, Sunmonu T, Olowoyo P, Agunloye AM, Adeoye AM, Yaria J, Lackland DT, Arnett D, Laryea RY, Adigun TO, Okekunle AP, Calys-Tagoe B, Ogah OS, Ogunronbi M, Obiabo OY, Isah SY, Dambatta HA, Tagge R, Ogenyi O, Fawale B, Melikam CL, Onasanya A, Adeniyi S, Akinyemi R, and Ovbiagele B
- Subjects
- Age Factors, Case-Control Studies, Comorbidity, Female, Ghana epidemiology, Hemorrhagic Stroke diagnostic imaging, Humans, Ischemic Stroke diagnostic imaging, Life Style ethnology, Male, Middle Aged, Nigeria epidemiology, Predictive Value of Tests, Race Factors, Reproducibility of Results, Risk Assessment, Risk Factors, Social Determinants of Health, Socioeconomic Factors, Black People, Decision Support Techniques, Hemorrhagic Stroke ethnology, Ischemic Stroke ethnology
- Abstract
Background: Stroke risk can be quantified using risk factors whose effect sizes vary by geography and race. No stroke risk assessment tool exists to estimate aggregate stroke risk for indigenous African., Objectives: To develop Afrocentric risk-scoring models for stroke occurrence., Materials and Methods: We evaluated 3533 radiologically confirmed West African stroke cases paired 1:1 with age-, and sex-matched stroke-free controls in the SIREN study. The 7,066 subjects were randomly split into a training and testing set at the ratio of 85:15. Conditional logistic regression models were constructed by including 17 putative factors linked to stroke occurrence using the training set. Significant risk factors were assigned constant and standardized statistical weights based on regression coefficients (β) to develop an additive risk scoring system on a scale of 0-100%. Using the testing set, Receiver Operating Characteristics (ROC) curves were constructed to obtain a total score to serve as cut-off to discriminate between cases and controls. We calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) at this cut-off., Results: For stroke occurrence, we identified 15 traditional vascular factors. Cohen's kappa for validity was maximal at a total risk score of 56% using both statistical weighting approaches to risk quantification and in both datasets. The risk score had a predictive accuracy of 76% (95%CI: 74-79%), sensitivity of 80.3%, specificity of 63.0%, PPV of 68.5% and NPV of 76.2% in the test dataset. For ischemic strokes, 12 risk factors had predictive accuracy of 78% (95%CI: 74-81%). For hemorrhagic strokes, 7 factors had a predictive accuracy of 79% (95%CI: 73-84%)., Conclusions: The SIREN models quantify aggregate stroke risk in indigenous West Africans with good accuracy. Prospective studies are needed to validate this instrument for stroke prevention., (Copyright © 2021 Elsevier Inc. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
138. Knowledge, attitudes and practices of West Africans on genetic studies of stroke: Evidence from the SIREN Study.
- Author
-
Akinyemi RO, Sarfo FS, Akinyemi J, Singh A, Onoja Akpa M, Akpalu A, Owolabi L, Adeoye AM, Obiako R, Wahab K, Sanya E, Komolafe M, Ogbole G, Fawale M, Adebayo P, Osaigbovo G, Sunmonu T, Olowoyo P, Chukwuonye I, Obiabo Y, Adeniji O, Fakunle G, Melikam E, Saulson R, Yaria J, Uwanruochi K, Ibinaiye P, Amusa GA, Yahaya IS, Dambatta AH, Faniyan M, Olowoniyi P, Bock-Oruma A, Joseph OC, Oguntade A, Kolo P, Laryea R, Lakoh S, Uvere E, Farombi T, Akpalu J, Oyinloye O, Appiah L, Calys-Tagoe B, Shidali V, Tabari NA, Adebayo O, Efidi R, Adeleye O, Owusu D, Ogunjimi L, Aridegbe O, Imoh CL, Sanni T, Gebreziabher M, Hemant T, Arulogun O, Ogunniyi A, Jenkins C, Owolabi M, and Ovbiagele B
- Subjects
- Adult, Africa, Western epidemiology, Aged, Cross-Sectional Studies, Developing Countries, Female, Ghana epidemiology, Humans, Male, Middle Aged, Nigeria epidemiology, Risk Factors, Socioeconomic Factors, Stroke epidemiology, Surveys and Questionnaires, Black People, Health Knowledge, Attitudes, Practice, Stroke genetics
- Abstract
Background: It is crucial to assess genomic literacy related to stroke among Africans in preparation for the ethical, legal and societal implications of the genetic revolution which has begun in Africa., Objective: To assess the knowledge, attitudes and practices (KAP) of West Africans about stroke genetic studies., Methods: A comparative cross-sectional study was conducted among stroke patients and stroke-free controls recruited across 15 sites in Ghana and Nigeria. Participants' knowledge of heritability of stroke, willingness to undergo genetic testing and perception of the potential benefits of stroke genetic research were assessed using interviewer-administered questionnaire. Descriptive, frequency distribution and multiple regression analyses were performed., Results: Only 49% of 2029 stroke patients and 57% of 2603 stroke-free individuals knew that stroke was a heritable disorder. Among those who knew, 90% were willing to undergo genetic testing. Knowledge of stroke heritability was associated with having at least post-secondary education (OR 1.51, 1.25-1.81) and a family history of stroke (OR 1.20, 1.03-1.39) while Islamic religion (OR=0.82, CI: 0.72-0.94), being currently unmarried (OR = 0.81, CI: 0.70-0.92), and alcohol use (OR = 0.78, CI: 0.67-0.91) were associated with lower odds of awareness of stroke as a heritable disorder. Willingness to undergo genetic testing for stroke was associated with having a family history of stroke (OR 1.34, 1.03-1.74) but inversely associated with a medical history of high blood pressure (OR = 0.79, 0.65-0.96)., Conclusion: To further improve knowledge of stroke heritability and willingness to embrace genetic testing for stroke, individuals with less formal education, history of high blood pressure and no family history of stroke require targeted interventions.
- Published
- 2019
- Full Text
- View/download PDF
139. PATTERN AND OUTCOME OF TETANUS IN A TERTIARY HEALTH FACILITY IN NORTH WEST NIGERIA.
- Author
-
Aliyu A, Dahiru T, Obiako RO, Amadu L, Biliaminu LB, and Akase EI
- Subjects
- Adult, Female, Hospitals, University, Humans, Incidence, Male, Nigeria epidemiology, Retrospective Studies, Young Adult, Tetanus epidemiology
- Abstract
Background: Tetanus, a disease that is largely preventable, is still a major public health problem in the developing world and is associated with high morbidity and mortality. There is a paucity of published literature on adult (non-neonatal) tetanus in this study area in Nigeria., Methods: This was a study describing the clinical characteristics of patients who were clinically diagnosed with tetanus in Ahmadu Bello University Teaching Hospital (ABUTH) Zaria, northwest of Nigeria between January 2001 and December 2014., Results: A total of 91 cases were reviewed. The mean patient age was 20 years, and male to female ratio 2.9:1. The majority (88%) of patients were < 40 years old. The mean onset period was 19 days, nearly all patients (96.7%) had generalized tetanus, and the commonest presenting signs were spasm (93.4%) and trimus (78.0%). The most common site of injury was lower limbs (64.8% of cases). The complication rate was 71.4% and case fatality was 48.4%., Conclusion: Tetanus is still a major public health problem in our setting and affects the younger age group with a high case fatality rate. The incidence of tetanus can be reduced drastically by an effective and sustained immunization program.
- Published
- 2016
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.