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Background: The relationship of diet with stroke risk among Africans is not well understood. Aim: The aim of this study was to investigate the association between dietary patterns and stroke risk among West Africans. Methods: In this multi-center case–control study, 3684 stroke patients matched (for age and sex) with 3684 healthy controls were recruited from Nigeria and Ghana. Food consumption was assessed using a food frequency questionnaire, and dietary patterns were summarized using principal component analysis. Stroke was defined using predefined criteria primarily on clinical evaluation following standard guidelines. Conditional logistic regression was applied to compute odds ratio (OR) and 95% confidence interval (CI) for stroke risk by tertiles of dietary patterns adjusting for relevant confounders. Results: Overall, mean age was 59.0 ± 13.9 years, and 3992 (54.2%) were males. Seven dietary patterns were identified. Multivariable-adjusted OR (95% CI) for risk of stroke by second and third tertiles (using the lowest and first tertile as reference) of dietary patterns was 1.65 (1.43, 1.90) and 1.74 (1.51, 2.02), for “poultry product and organ meat”; 1.69 (1.47, 1.96) and 1.51 (1.31, 1.75) for “red meat”; 1.07 (0.92, 1.23) and 1.21 (1.04, 1.40) for “fried foods and sweetened drinks”; 0.69 (0.60, 0.80) and 0.45 (0.39, 0.53) for “vegetables”; 0.84 (0.72, 0.97) and 0.81 (0.70, 0.93) for “whole-grain and fruit drinks”; and 0.97 (0.84, 1.12) and 0.85 (0.73, 0.98) for “fruits” respectively ( p Conclusion: These data suggest that plant-based diets are associated with a lower risk of stroke and might be a beneficial dietary recommendation for the primary prevention of stroke among Africans.

Hypertension is one of the most important risk factors for stroke and cardiovascular diseases (CVD) globally. Understanding risk factors for hypertension among individuals with matching characteristics with stroke patients may inform primordial/primary prevention of hypertension and stroke among them. This study identified the risk factors for hypertension among community‐dwelling stroke‐free population in Ghana and Nigeria. Data for 4267 community‐dwelling stroke‐free controls subjects in the Stroke Investigative Research and Education Network (SIREN) study in Nigeria and Ghana were used. Participants were comprehensively assessed for sociodemographic, lifestyle and metabolic factors using standard methods. Hypertension was defined as a previous diagnosis by a health professional or use of an anti‐hypertensive drug or mean systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. Logistic regression analysis was used to estimate adjusted odds ratios (aOR) of hypertension and their 95% confidence intervals (CI) at p

BACKGROUND: Laboratory - based studies of neurological disease patterns and mechanisms are sparse in sub- Saharan Africa. However, availability of human brain tissue resource depends on willingness towards brain donation. This study evaluated the level of willingness among outpatient clinic attendees in a Nigerian teaching hospital. METHODS: Under the auspices of the IBADAN Brain Bank Project, a 43 – item semi - structured interviewer – administered questionnaire was designed to evaluate knowledge, attitude, and beliefs of individuals attending Neurology, Psychiatry and Geriatrics Outpatient clinics regarding willingness to donate brain for research. Association between participants characteristics and willingness towards brain donation was investigated using logistic regression models. Analysis was conducted using Stata SE version 12.0. RESULTS: A total of 412 participants were interviewed. Their mean age was 46.3 (16.1) years. 229 (55.6%) were females and 92.5% had at least 6 years of formal education. Overall, 109 (26.7%) were willing to donate brains for research. In analyses adjusting for educational status, religion, ethnicity, marital status and family setting, male sex showed independent association with willingness towards brain donation OR (95% C.I) = 1.7 (1.08 – 2.69), p = 0.023. Participants suggested public engagement and education through mass media (including social media) and involvement of religious and community leaders as important interventions to improve awareness and willingness towards brain donation. CONCLUSION: The survey revealed low willingness among outpatient clinic attendees to donate brain for research, although men were more inclined to donate. It is imperative to institute public engagement and educational interventions in order to improve consent for brain donation for research.

Summary: Background: Sub-Saharan Africa has the highest incidence, prevalence, and fatality from stroke globally. Yet, only little information about context-specific risk factors for prioritising interventions to reduce the stroke burden in sub-Saharan Africa is available. We aimed to identify and characterise the effect of the top modifiable risk factors for stroke in sub-Saharan Africa. Methods: The Stroke Investigative Research and Educational Network (SIREN) study is a multicentre, case-control study done at 15 sites in Nigeria and Ghana. Cases were adults (aged ≥18 years) with stroke confirmed by CT or MRI. Controls were age-matched and gender-matched stroke-free adults (aged ≥18 years) recruited from the communities in catchment areas of cases. Comprehensive assessment for vascular, lifestyle, and psychosocial factors was done using standard instruments. We used conditional logistic regression to estimate odds ratios (ORs) and population-attributable risks (PARs) with 95% CIs. Findings: Between Aug 28, 2014, and June 15, 2017, we enrolled 2118 case-control pairs (1192 [56%] men) with mean ages of 59·0 years (SD 13·8) for cases and 57·8 years (13·7) for controls. 1430 (68%) had ischaemic stoke, 682 (32%) had haemorrhagic stroke, and six (

Background: Whether left ventricular hypertrophy (LVH) is determined by similar genomic and environmental risk factors with stroke, or is simply an intermediate stroke marker, is unknown.Objectives: We present a research plan and preliminary findings to explore the overlap in the genomic and environmental determinants of LVH and stroke among Africans participating in the SIREN (Stroke Investigative Research and Education Network) study.Methods: SIREN is a transnational, multicenter study involving acute stroke patients and age-, ethnicity-, and sex-matched control subjects recruited from 9 sites in Ghana and Nigeria. Genomic and environmental risk factors and other relevant phenotypes for stroke and LVH are being collected and compared using standard techniques.Results: This preliminary analysis included only 725 stroke patients (mean age 59.1 ± 13.2 years; 54.3% male). Fifty-five percent of the stroke subjects had LVH with greater proportion among women (51.6% vs. 48.4%; p < 0.001). Those with LVH were younger (57.9 ± 12.8 vs. 60.6 ± 13.4; p = 0.006) and had higher mean systolic and diastolic blood pressure (167.1/99.5 mm Hg vs 151.7/90.6 mm Hg; p < 0.001). Uncontrolled blood pressure at presentation was prevalent in subjects with LVH (76.2% vs. 57.7%; p < 0.001). Significant independent predictors of LVH were age90 mm Hg (AOR: 2.10; 95% CI: 1.39 to 3.19; p < 0.001).Conclusions: The prevalence of LVH was high among stroke patients especially the younger ones, suggesting a genetic component to LVH. Hypertension was a major modifiable risk factor for stroke as well as LVH. It is envisaged that the SIREN project will elucidate polygenic overlap (if present) between LVH and stroke among Africans, thereby defining the role of LVH as a putative intermediate cardiovascular phenotype and therapeutic target to inform interventions to reduce stroke risk in populations of African ancestry.HighlightsLeft ventricular hypertrophy (LVH) was found in more than one-half of stroke patients in Africa.LVH was more common in younger patients, suggesting a genetic component.Hypertension was a major modifiable risk factor for stroke as well as LVH.SIREN will elucidate polygenic overlap between LVH and stroke among Africans.

Context: The coexistence of human immunodeficiency virus (HIV) with non communicable disease risk factors is an emerging public health problem in sub-Saharan Africa. Aims: We investigated the prevalence and risk factors of obesity, hypertension, and dyslipidemia among HIV-positive patients in Abeokuta. Settings and Design: This was a cross-sectional study done using 206 persons living with HIV in three hospitals at Abeokuta, South Western Nigeria. Subjects and Methods: The WHO stepwise interviewer-administered questionnaire was used for data collection. Specific clinical information on HIV treatment status and traditional cardiovascular risk factors were assessed. Data were analyzed using descriptive statistics, Chi-square, and multivariate logistic regression at P Results: The prevalence of overweight/obesity was 34.0% (95% confidence interval [CI]: 27.5–40.5); 20.9% (95% CI: 15.3–26.4) for hypertension; and 40.2% (95% CI: 33.5–47.0) for dyslipidemia. Risk factors for obesity were sedentary time (odds ratio [OR] 1.2; 95% CI: 1.0–1.3), hypertension (OR 3.0; 95% CI: 1.1–6.0), and increasing duration of HIV (OR for 2–5 years = 2.0; 95% CI: 1.0–4.1 and OR for >5 years = 3.0; 95% CI: 1.0–6.3). Age >40 years (OR 7.9; CI: 2.7–23) and CD4 level ≥ 350/μl (OR 3.9; 95% CI: 1.0–14.6) were risk factors for hypertension while female sex protected against hypertension (OR 0.2; 95% CI: 0.1–0.6). None of the measured covariates predicted dyslipidemia. Conclusion: Obesity, hypertension, and dyslipidemia are common in HIV patients in Nigeria. HIV patients would benefit from cardiovascular diseases screening programs just like the general adult population if the gains of HIV care are not to be reversed.