FACULTY OF PUBLIC HEALTH

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Author: search.filters.author.Akinyemi R. O.Subject: search.filters.subject.stroke

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    Knowledge, attitudes and practices of West Africans on genetic studies of stroke: Evidence from the SIREN Study
    (World Stroke Organization Reprints and permissions, 2018) Akinyemi R. O.; Sarfo F. S.; Akinyemi J.; Singh A.; Akpa M. O.; Akpalu A.; Owolabi L.; Adeoye A. M.; Obiako R.; Wahab K.; Sanya E.; Komolafe M.; Ogbole G.; Fawale M.; Adebayo P.; Osaigbovo G.; Sunmonu T.; Olowoyo P.; Chukwuonye I.; Obiabo Y.; Adeniji O.; Fakunle G.; Melikam E.; Saulson R.; Yaria J.; Uwanruochi K.
    Background: It is crucial to assess genomic literacy related to stroke among Africans in preparation for the ethical, legal and societal implications of the genetic revolution which has begun in Africa. Objective: To assess the knowledge, attitudes and practices (KAP) of West Africans about stroke genetic studies. Methods: A comparative cross-sectional study was conducted among stroke patients and stroke-free controls recruited across 15 sites in Ghana and Nigeria. Participants’ knowledge of heritability of stroke, willingness to undergo genetic testing and perception of the potential benefits of stroke genetic research were assessed using interviewer-administered questionnaire. Descriptive, frequency distribution and multiple regression analyses were performed. Results: Only 49% of 2029 stroke patients and 57% of 2603 stroke-free individuals knew that stroke was a heritable disorder. Among those who knew, 90% were willing to undergo genetic testing. Knowledge of stroke heritability was associated with having at least post-secondary education (OR 1.51, 1.25–1.81) and a family history of stroke (OR 1.20, 1.03–1.39) while Islamic religion (OR¼0.82, CI: 0.72–0.94), being currently unmarried (OR ¼ 0.81, CI: 0.70–0.92), and alcohol use (OR ¼ 0.78, CI: 0.67–0.91) were associated with lower odds of awareness of stroke as a heritable disorder. Willingness to undergo genetic testing for stroke was associated with having a family history of stroke (OR 1.34, 1.03– 1.74) but inversely associated with a medical history of high blood pressure (OR ¼ 0.79, 0.65–0.96). Conclusion: To further improve knowledge of stroke heritability and willingness to embrace genetic testing for stroke, individuals with less formal education, history of high blood pressure and no family history of stroke require targeted interventions
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    Stroke Among Young West Africans Evidence From the SIREN (Stroke Investigative Research and Educational Network) Large Multisite Case–Control Study.
    (American Heart Association, Inc., 2019) Sarfo F. S.; Ovbiagele B.; Gebregziabher M.; Wahab K.; Akinyemi R. O.; Akpalu A.; Akpa O.; Obiako R.; Owolabi L.; Jenkins C.; Owolabi M. O.
    Background and purpose: Stroke in lower and middle-income countries affects a young and productive age group. Data on factors associated with stroke in the young are sorely lacking from lower and middle-income countries. Our objective is to characterize the nature of stroke and its risk factors among young West Africans aged <50 years old. Methods: The SIREN (Stroke Investigative Research and Educational Network) is a multicenter, case-control study involving 15 sites in Nigeria and Ghana. Cases included adults aged ≥18 years with computed tomography/magnetic resonance imaging-confirmed stroke. Controls were age-and gender-matched stroke-free adults recruited from the communities in catchment areas of cases. Comprehensive evaluation for vascular, lifestyle, and psychosocial factors was performed. We used conditional logistic regression to estimate odds ratios and population attributable risks with 95% confidence intervals. Results: Five hundred fifteen (24.3%) out of 2118 cases enrolled were <50 years old. Among subjects <50 years old, hemorrhagic stroke proportion was 270 (52.5%) versus 245 (47.5%) for ischemic strokes. Etiologic subtypes of ischemic strokes included large artery atherosclerosis (40.0%), small vessel disease (28.6%), cardioembolism (11.0%), and undetermined (20.4%). Hypertension (91.7%), structural lesions (3.4%), and others (4.9%) were causally associated with hemorrhagic stroke. Six topmost modifiable factors associated with stroke in descending order of population attributable risk (95% confidence interval) were hypertension: 88.7% (82.5%-94.8%), dyslipidemia: 48.2% (30.6%-65.9%), diabetes mellitus: 22.6% (18.7%-26.5%), low green vegetable consumption: 18.2% (-6.8%-43.2%), stress: 14.5% (4.9%-24.1%), and cardiac disease: 8.4% (5.8%-11.1%). Conclusions: The high and rising burden of stroke among young Africans should be curtailed via aggressive, population-wide vascular risk factor control.