Jørgensen Jutta M Adelin, Christensen Dirk Lund, Nielsen Karoline Kragelund, Sadiq Halima Saleh, Khan Muhammad Yusuf, Jusabani Ahmed M, Walker Richard
Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Mnazi Mmoja Referral Hospital, Zanzibar, Tanzania.
Front Neurol. 2022 Jul 28;13:931915. doi: 10.3389/fneur.2022.931915. eCollection 2022.
Stroke in adults is a critical clinical condition and a leading cause of death and disability globally. Epidemiological data on stroke in sub-Saharan Africa are limited. This study describes incidence rates, stroke types and antecedent factors among patients hospitalized with stroke in Zanzibar.
This was a prospective, observational study of stroke patients at hospitals in Unguja, Zanzibar. Socioeconomic and demographic data were recorded alongside relevant past medical history, medicine use and risk factors. The modified National Institute of Health Stroke Scale (mNIHSS) was used to assess admission stroke severity and, when possible, stroke was confirmed by neuroimaging.
A total of 869 stroke admissions were observed from 1 October 2019 through 30 September 2020. Age-standardized to the World Health Organization global population, the yearly incidence was 286.8 per 100,000 adult population (95%CI: 272.4-301.9). Among these patients, 720 (82.9%) gave consent to participate in the study. Median age of participants was 62 years (53-70), 377 (52.2%) were women, and 463 (64.3%) had a first-ever stroke. Known stroke risk factors included hypertension in 503 (72.3%) patients, of whom 279 (55.5%) reported regularly using antihypertensive medication, of whom 161 (57.7%) had used this medication within the last week before stroke onset. A total of 460 (63.9%) participants had neuroimaging performed; among these there was evidence of intracerebral hemorrhage (ICH) in 140 (30.4%). Median stroke severity score using mNIHSS was 19 (10-27).
Zanzibar has high incidence of hospitalization for stroke, indicating a very high population incidence of stroke. The proportion of strokes due to ICH is substantially higher than in high-income countries. Most stroke patients had been in contact with health care providers prior to stroke onset and been diagnosed with hypertension. However, few were using antihypertensive medication at the time of stroke onset.www.ClinicalTrial.gov registration NCT04095806.
成人中风是一种危急的临床病症，是全球死亡和残疾的主要原因。撒哈拉以南非洲地区中风的流行病学数据有限。本研究描述了桑给巴尔住院中风患者的发病率、中风类型及前驱因素。
这是一项对桑给巴尔温古贾岛医院中风患者进行的前瞻性观察性研究。记录社会经济和人口统计学数据以及相关既往病史、用药情况和风险因素。使用改良的美国国立卫生研究院卒中量表（mNIHSS）评估入院时的中风严重程度，如有可能，通过神经影像学确诊中风。
2019年10月1日至2020年9月30日期间共观察到869例中风入院病例。按照世界卫生组织全球人口年龄标准化后，年发病率为每10万成年人口286.8例（95%置信区间：272.4 - 301.9）。在这些患者中，720例（82.9%）同意参与研究。参与者的中位年龄为62岁（53 - 70岁），377例（52.2%）为女性，463例（64.3%）为首次中风。已知的中风风险因素包括503例（72.3%）患者患有高血压，其中279例（55.5%）报告定期使用抗高血压药物，其中161例（57.7%）在中风发作前最后一周内使用过该药物。共有460例（63.9%）参与者进行了神经影像学检查；其中140例（30.4%）有脑出血（ICH）证据。使用mNIHSS的中位中风严重程度评分为19分（10 - 27分）。
桑给巴尔中风住院率很高，表明中风的人群发病率非常高。脑出血所致中风的比例显著高于高收入国家。大多数中风患者在中风发作前曾与医疗服务提供者接触并被诊断患有高血压。然而，中风发作时很少有人使用抗高血压药物。ClinicalTrial.gov注册号NCT04095806。
