title: Stroke survivors in Nigeria: A door-to-door prevalence survey from the Niger Delta region.
abstract: The burden of stroke has been projected to increase in low-and middle-income countries due to the ongoing epidemiological transition. However, community-based stroke prevalence studies are sparse in sub-Saharan Africa particularly in Nigeria. This study aimed to provide a comparative estimate of the prevalence of stroke survivors in the rural Niger Delta region. A three-phased door-to-door survey was conducted using WHO modified instruments. In the first-phase, 2028 adults (≥18years) participants randomly selected from two rural communities were screened by trained health research assistants for probable stroke. In the second phase, suspected cases were screened with stroke-specific tool. Positive cases were made to undergo complete neurological evaluation by two study neurologist in phase-three. Stroke diagnosis was based on clinical evaluation using WHO criteria. Overall, 27 (8 first-ever and 19 recurrent cases) stroke survivors with crude prevalence of 13.31/1000 (95% CI, 8.32-18.31) and a non-significant difference in prevalence between the two study communities were found, (P=0.393I). In addition, age-adjusted prevalence of stroke survivors was 14.6/1000 person, about 7-folds higher than previous estimates outside the Niger Delta region. The prevalence increases significantly with advancing in age, P<0·001. Among others, hypertension (92.59%) was the commonest risk factor and comorbidity found. Improved stroke surveillance and care, as well as better management of the underlying risk factors, primarily undetected or uncontrolled high blood pressure, remains a public health priority.
authors.affiliation: Division of Health Sciences, University of Warwick Medical School, Coventry, CV4 7AL, UK. Electronic address: m.c.ezejimofor@warwick.ac.uk.
authors.forename: Martinsixtus C
authors.initials: MC
authors.lastname: Ezejimofor
authors.affiliation: Division of Health Sciences, University of Warwick Medical School, Coventry, CV4 7AL, UK; Warwick-Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, University of Warwick Medical School, Coventry, UK; Liverpool School of Tropical Medicine, International Health Group, Liverpool, UK.
authors.forename: Olalekan A
authors.initials: OA
authors.lastname: Uthman
authors.affiliation: Department of Preventive and Social Medicine, University of Port Harcourt, Port Harcourt, Nigeria.
authors.forename: Omosivie
authors.initials: O
authors.lastname: Maduka
authors.affiliation: School of the Built Environment, University of Salford, M5 4WT, UK.
authors.forename: Aloysius C
authors.initials: AC
authors.lastname: Ezeabasili
authors.affiliation: Department of Internal Medicine, University of Port Harcourt, Port Harcourt, Nigeria.
authors.forename: Arthur C
authors.initials: AC
authors.lastname: Onwuchekwa
authors.affiliation: Division of Health Sciences, University of Warwick Medical School, Coventry, CV4 7AL, UK.
authors.forename: Benedeth C
authors.initials: BC
authors.lastname: Ezejimofor
authors.affiliation: Department of Preventive and Social Medicine, University of Port Harcourt, Port Harcourt, Nigeria.
authors.forename: Eme
authors.initials: E
authors.lastname: Asuquo
authors.affiliation: Division of Health Sciences, University of Warwick Medical School, Coventry, CV4 7AL, UK; Warwick-Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, University of Warwick Medical School, Coventry, UK.
authors.forename: Yen-Fu
authors.initials: YF
authors.lastname: Chen
authors.affiliation: Department of Population Health, Luxembourg Institute of Health (LIH), 1A-B, rue Thomas Edison, L-1445 Strassen, Luxembourg; Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
authors.forename: Saverio
authors.initials: S
authors.lastname: Stranges
authors.affiliation: Division of Health Sciences, University of Warwick Medical School, Coventry, CV4 7AL, UK; Department of Population Health, Luxembourg Institute of Health (LIH), 1A-B, rue Thomas Edison, L-1445 Strassen, Luxembourg; Department of Mathematics and Information Sciences, Faculty of Engineering and Environment, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK; University of Agder, Faculty of Health and Sport Sciences, Kristiansand, Norway; University of the Witwatersrand, Division of Epidemiology and Biostatistics, School of Public Health, Johannesburg, South Africa.
authors.forename: Ngianga-Bakwin
authors.initials: NB
authors.lastname: Kandala
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009548:Niger / Q000453:epidemiology; D015995:Prevalence; D012424:Rural Population; D020521:Stroke / Q000453:epidemiology* / Q000401:mortality*; D055815:Young Adult
keywords: Cross-sectional; Niger delta; Nigeria; Prevalence; Rural; Stroke survivor