Emmanuel Sagui

Stroke is the second cause of mortality worldwide and 87% of deaths are recorded in developing countries. Due to biases in most studies, the prevalence and incidence of stroke in sub-Saharan Africa remains unclear. In comparison with industrialized countries, sub-Saharan countries present several differences, i.e., higher mortality rate, younger age at onset, and hypertension as the main risk factor for stroke. Conversely the distribution of ischemic and hemorrhagic stroke in developing countries appears to be the same as in industrialized countries. Without appropriate public health policies, the coming years are likely to witness an epidemic of non-communicable diseases in sub-Saharan Africa and stroke will probably become the second most common cause of morbidity and mortality.

Background and Purpose— Basic stroke features are hardly known in sub-Saharan countries, and no data are available in Senegal. Methods— We performed a retrospective hospital-based study in Dakar, Senegal, to assess risk factors and etiology of stroke. Patients were recruited from January 1, 2003, to July 31, 2004, at the Hôpital Principal, Dakar. Strokes had to be ascertained by computed tomography. Results— A total of 107 patients were studied. Seventy percent of strokes were of ischemic nature. For ischemic strokes, mean age was 64.2 years. Hypertension was the main risk factor, occurring in 68%, and diabetes was encountered in 37.3%. Lacunar strokes and cardioembolism accounted for 20% and 13.3%, respectively. Because of the lack of systematic investigations, two thirds of strokes were of undetermined origin. Mortality within 1 month was 38%. For hemorrhagic strokes, mean age was 51 years and 1 month mortality was 56%. Conclusion— Hypertension is the main risk factor for both ischemic and hemorrhagic strokes in this hospital-based study.