ABSTRACT
BACKGROUND: Stroke can be prevented with treatments targeted at hypertension, diabetes mellitus, hyperlipidemia and atrial fibrillation, but this is often hampered by under-diagnosis and under-treatment of those risk factors. The magnitude of this problem is not well-studied in sub-Saharan Africa. MATERIALS AND METHODS: We conducted a cross-sectional survey of stroke patients at a tertiary hospital during January 2010 to July 2013 to determine patient awareness of a pre-existing stroke risk factor and prior use of anti-hypertensive, anti-diabetic, antiplatelet and lipid-lowering agents. We also investigated whether gender and school education influenced patient awareness and treatment of a stroke risk factor prior to stroke. RESULTS: Three hundred and sixty nine stroke patients presented during the study period, of which 344 eligible subjects were studied. Mean age at presentation (±SD) was 55.8 ± 13.7 years, and was not different for men and women. Hypertension, hyperlipidemia, diabetes and atrial fibrillation were prevalent among 83.7%, 26.5%, 25.6% and 9.6% patients respectively. Awareness was high for pre-existing diabetes (81.8%) and hypertension (76.7%), but not for hyperlipidemia (26.4%) and atrial fibrillation (15.2%). Men were better educated than women (p = 0.002), and had better awareness for hyperlipidemia (37.3% versus 13.5%; p = 0.009). Men were also more likely to take drug treatments for a stroke risk factor, but the differences were significant. CONCLUSIONS: A high rate of under-diagnosis and under-treatment of hypertension, hyperlipidemia and atrial fibrillation contributes to the stroke burden in sub-Saharan Africa, especially among women. Public health measures including mass media campaigns could help reduce the burden of stroke.
Subject(s)
Atrial Fibrillation/epidemiology , Diabetes Mellitus/epidemiology , Health Knowledge, Attitudes, Practice , Hyperlipidemias/epidemiology , Hypertension/epidemiology , Stroke/epidemiology , Adult , Aged , Aged, 80 and over , Antihypertensive Agents/therapeutic use , Atrial Fibrillation/complications , Atrial Fibrillation/prevention & control , Awareness , Diabetes Mellitus/drug therapy , Educational Status , Female , Humans , Hyperlipidemias/complications , Hyperlipidemias/drug therapy , Hypertension/complications , Hypertension/drug therapy , Hypoglycemic Agents/therapeutic use , Hypolipidemic Agents/therapeutic use , Male , Middle Aged , Nigeria/epidemiology , Prevalence , Risk Factors , Sex Factors , Stroke/diagnosis , Stroke/prevention & control , Surveys and QuestionnairesABSTRACT
OBJECTIVE: The purpose of this study was to determine the normal range of spleen size in an adult African population, and compare the findings to published data to determine any correlation with ethnicity. MATERIALS AND METHODS: Three hundred and seventy-four African adults without conditions that can affect the spleen or splenic abnormalities were evaluated with ultrasonography. Spleen length, width and thickness were measured and spleen volume calculated. Spleen size was correlated with age, gender, height, weight, and body mass index. RESULTS: The mean spleen volume was 120 cm(3). Spleen volume correlated with spleen width (r=0.85), thickness (r=0.83) and length (r=0.80). Men had a larger mean spleen volume than women. No correlation was found between spleen volume and age, weight, height, or body mass index. CONCLUSION: Mean spleen volume in African adults is smaller than data from Western sources, and cannot be explained by difference in body habitus.