Stroke in developing countries : experience at Kano, Northwestern Nigeria

Abstract EN

Objectives : As no report on the clinical pattern of stroke in Kano is available, we sought to determine the stroke types, the risk factors associated with stroke, reasons for delay presentation, management issues and outcome of stroke in Kano, Northwestern Nigeria.

Methods : In this prospective study, consecutive patients that were admitted to the medical wards of the two tertiary hospitals ; Aminu Kano Teaching Hospital (AKTH), Kano and Murtala Muhammad Specialist Hospital, (MMSH) Kano, from June 2008 to June 2010 was recruited in the study.

Diagnosis of stroke and its type were determined by clinical and neuroimaging techniques.

Risk factor analysis was made based on clinical, laboratory and other relevant investigational data.

The case fatality at 24 hours and 7 days were recorded.

The survivors were followed in neurology clinics for 6 months ; status of disability on admission and at discharge was recorded using modified Rankin disability scale.

Results : Over a period of 3 years, a total of 273 comprising 179 males and 94 females (m : f = 2 : 1) stroke patients were recruited.

Their age ranged between 18 and 90 with a mean age of 55 yrs (sd-16.5) but the mean age was 52 (s.d = 17.6) in males and 60 (s.d = 11.5) in females.

The peak age was in the seventh decade.

One hundred and seventy four (63.7 %) had infarctive stroke while ninety nine (36.3 %) had haemorhagic stroke (91 intracerebral and 8 subarachnoid haemorhage).

Reasons for the delay included delay referral from private hospital (49.1 %), visit to traditional homes before coming to hospital (10.6 %), treatment at home (7 %), transportation problem (32.2 %) and others (1.1 %).

Overall one hundred and seventy one (63 %) survived and one hundred and two (37 %) died.

The case fatality for stroke was 10 % in the first 24 hours and 22 % at 7 days.

Conclusion : the clinical pattern and outcome of stroke found in this study are similar to that reported in other geopolitical zones of Nigeria and other developing countries.