Prevalence of Recurrent Stroke among a Rehabilitation Cohort in Nigeria.

OBJECTIVE: A recurrent stroke increases the rates of mortality and morbidity after an initial stroke. There is, however, a dearth of data on the prevalence of recurrent stroke in Nigeria. METHODS: A secondary analysis of the data obtained from 100 stroke survivors undergoing physiotherapy at 2 health facilities in Nigeria was carried out to document the prevalence of recurrent stroke. The association between recurrent stroke and selected socio-demographic and clinical factors of the participants was explored using logistic regression analysis. RESULTS: Thirty-two (32%) participants had had a recurrent stroke. Employment status and educational level were significantly associated with recurrent stroke. The outcome of the logistic regression analysis further showed that participants who were employed (OR = 0.08; P<0.001; 95% CI = 0.02-0.32) and who had no formal education (OR = 0.22; P = 0.03; 95% CI = 0.05-0.87) were significantly less likely to present with recurrent stroke compared to the unemployed participants and those who had tertiary educational qualification, respectively. CONCLUSION: Approximately 1 in 3 stroke survivors undergoing rehabilitation had experienced stroke recurrence. The finding of this study buttresses the urgent need to emphasize and aggressively pursue secondary stroke prevention. Further studies are, however, required to explore those potentially modifiable factors that are associated with recurrent stroke, and having more representative samples.

Impact of poststroke fatigue on health-related quality of life of nigerian stroke survivors.

BACKGROUND AND PURPOSE: A stroke event is often characterized by a number of debilitating consequences that may impact negatively on the health-related quality of life (HRQL) of survivors. This study examined the impact of poststroke fatigue (PSF), a persistent and prevalent stroke consequence, on HRQL of Nigerian stroke survivors. METHODS: One hundred stroke survivors were recruited from the physiotherapy outpatient departments of two tertiary hospitals in Northern Nigeria. The Fatigue Severity Scale and Health-Related Quality of Life in Stroke Patients-26 were respectively used to assess PSF and HRQL. The independent impact of PSF on overall and domain-specific HRQL was examined using hierarchical regression analyses. RESULTS: Mean age of the stroke survivors was 55.32 years (SD 13.9 years). The majority were males (66%), had suffered ischemic stroke (70%) and presented with moderately severe disability (42%). After controlling for demographic and stroke-related variables, PSF was found to be significantly and independently associated with all the domains of HRQL albeit at varying degrees. While the influence of PSF on the emotional domain was the most pronounced and uniquely contributed to 15% of the variance in the domain, its influence on the cognitive domain was the least prominent. PSF also solely accounted for 9% of the variation in overall HRQL with higher levels of PSF related with lower HRQL. CONCLUSIONS: Being a potentially treatable condition, PSF's significant impact on HRQL has implications for successful stroke care and rehabilitation. For instance, addressing PSF through appropriate interventions may assist in enhancing HRQL of stroke survivors.