title: [Impact of seasons, years El Nino/La Nina and rainfalls on stroke-related morbidity and mortality in Kinshasa].
abstract: BACKGROUND
  The significant impact of seasonality and climate change on stroke-related morbidity and mortality is well established, however, some findings on this issue are conflicting. The objective was to determine the impact of gender, age, season, year of admission, temperature, rainfall and El Nino phenomenon on ischemic and hemorrhagic strokes and fatal cases of stroke.
  
  
  METHODS
  The study was carried out at the teaching hospital of Kinshasa, DRC, between January 1998 and December 2004. Rainy and dry seasons, elevated temperatures, indices of rainfalls El Nino years 1998, 2002 and 2004, but La Nina years 1999-2000 and neutral/normal years 2001 and 2003 were defined.
  
  
  RESULTS
  Among 470 incident strokes, 34.5% of victims (n=162) died. Traditional seasons (small dry season, small rainy season, great dry season, great rainy season) and temperatures did not significantly (P>0.005) impact on stroke incidence. However, there was a positive association between the decrease in rainfall, El Nino, and incident ischemic strokes, but a significant positive association between the increase in rainfall, La Nina, and incident hemorrhagic strokes. Using logistic regression analysis, age ≥ 60 years (OR: 1.7, 95% CI: 1.2-2.5; P=0.018) and El Nino years (OR: 2, 95% CI: 1.2-3.3; P=0.009) were identified as the independent predictors of fatal strokes.
  
  
  CONCLUSIONS
  Early warning systems should be developed to predict the impact of seasons and climate variability on stroke morbidity and mortality.
authors.affiliation: Service de cardiologie, cliniques universitaires de Kinshasa, Kinshasa, République démocratique du Congo.
authors.forename: F
authors.initials: F
authors.lastname: Kintoki Mbala
authors.affiliation: Faculty of Health Sciences, Walter Sisulu University, Private Bag X1, Mthatha 5117 Eastern Cape, Afrique du Sud. Electronic address: longombenza@gmail.com.
authors.forename: B
authors.initials: B
authors.lastname: Longo-Mbenza
authors.affiliation: Laboratoire d'épidémiologie clinique et de biostatistique, Lomo Medical, Kinshasa, République démocratique du Congo.
authors.forename: S
authors.initials: S
authors.lastname: Mbungu Fuele
authors.affiliation: Faculté de médecine, université Simon Kimbangu, Kinshasa, République démocratique du Congo.
authors.forename: N
authors.initials: N
authors.lastname: Zola
authors.affiliation: Faculté de médecine, université Simon Kimbangu, Kinshasa, République démocratique du Congo.
authors.forename: D
authors.initials: D
authors.lastname: Motebang
authors.affiliation: Faculté de médecine, université Simon Kimbangu, Kinshasa, République démocratique du Congo.
authors.forename: V
authors.initials: V
authors.lastname: Nakin
authors.affiliation: Faculty of Health Sciences, Walter Sisulu University, Private Bag X1, Mthatha 5117 Eastern Cape, Afrique du Sud.
authors.forename: C
authors.initials: C
authors.lastname: Lueme Lokotola
authors.affiliation: Faculté d'agronomie, université de Lubumbashi, Lubumbashi, République démocratique du Congo.
authors.forename: N
authors.initials: N
authors.lastname: Simbarashe
authors.affiliation: Risk and Vulnerability Assessment Centre, Walter Sisulu University, Mthatha, Afrique du Sud.
authors.forename: A
authors.initials: A
authors.lastname: Nge Okwe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D057231:Climate Change; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D055864:Droughts; D059000:El Nino-Southern Oscillation; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D011891:Rain; D012189:Retrospective Studies; D012621:Seasons; D020521:Stroke / Q000453:epidemiology* / Q000401:mortality; D013696:Temperature; D055815:Young Adult
keywords: Accident vasculaire cérébral; Afrique Centrale; Central Africa; Climate change; El Nino; Réchauffement planétaire; Saisons; Seasons; Stroke