[A comparison of stroke patients' characteristics between a sub-Saharan Africa population (Abidjan) and a French stroke unit (Amiens): An observational study]

Rev Neurol (Paris). 2013 Mar;169(3):258-65. doi: 10.1016/j.neurol.2012.07.024. Epub 2013 Feb 12.
[Article in French]

Abstract

Introduction: Stroke characteristics in Sub-Saharan Africa (SSA) differ from developed countries. However, SSA subjects undergo epidemiological and demographic transition and it appears that the prevalence of vascular risk factors (RF) increases in this population. Here we aimed to compare stroke patients' characteristics between a SSA hospital (Cocody University Hospital, Abidjan, Côte d'Ivoire) and a French stroke unit (Amiens University Hospital, Amiens, France).

Methods: This retrospective study included all consecutive stroke patients admitted between January and May 2008 (Cocody University Hospital, Abidjan, Côte d'Ivoire) and between October and December 2008 (Amiens University Hospital, Amiens, France). We assessed each patient's demographic details, RF, and CT confirmed pathological stroke type. The glomerular filtration rate (GFR) was estimated using the four-component Modification of Diet in Renal Disease (MDRD) equation and CKD was defined as a GFR less than 60ml/min/1.73 m(2).

Results: One hundred and ninety five patients were included (Amiens: 92; Abidjan: 103) with a mean age of 63±14 years. Patients in Amiens had more known vascular RF than African patients, whereas African patients had more RF discovered during hospitalisation. Furthermore, CKD was significantly more common in SSA patients (43% vs 24%, P=0.001). More African than European patients had cerebral hemorrhage (34% vs 8%, P<0.001) but acute stroke mortality and treatments at hospital discharge were similar between the two hospitals. Finally, a high proportion of patients in Abidjan suffered from cervical atherosclerosis, although it was significantly lower than patients in Amiens (37% vs 67%, P<0.001).

Conclusion: Although this was a hospital-based study, CKD appears to be very common in SSA acute stroke patients. These findings could partly explain the high prevalence of cervical atherosclerosis found in this population. These results warrant confirmation in prospective studies.

Publication types

  • Comparative Study
  • English Abstract

MeSH terms

  • Adult
  • Africa South of the Sahara / epidemiology
  • Aged
  • Aged, 80 and over
  • Cote d'Ivoire / epidemiology
  • Female
  • France / epidemiology
  • Hospital Units / statistics & numerical data
  • Hospitals, University / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stroke / epidemiology*
  • Stroke / therapy*
  • Young Adult