Stroke Mortality Continues to Ravage Sub-Saharan Africa: A Call to Action

Stroke is a leading cause of death and disability in sub-Saharan Africa (SSA).

We report results of early stroke case fatality rates (CFRs) among patients receiving usual care (UC) at Aminu Kano Teaching Hospital (AKTH) in Kano, Nigeria. Our observations on root cause of death was adjudicated by a panel of 5 stroke experts according to the Cardiovascular and Stroke Endpoint Definitions for Clinical Trials developed by the Standardized Data Collection for Cardiovascular Trials Initiative and US Food and Drug Administration (FDA) guidance.

Among 203 UC referral-based stroke study participants, early stroke CFRs were unusually high (in-hospital: 28%, 30-day: 31%, 90-day: 41%, and 180-day: 48%). The underlying cause of death was largely due to stroke (82%), however, there were many preventable contributing medical complications (e.g., aspiration pneumonitis, urinary tract infection, deep venous thrombosis).

We call for a concerted action to end the stroke death and disability epidemic that has plagued SSA for decades. In SSA, much of the morbidity and mortality associated with stroke is potentially preventable. Implementation of low-resource stroke units may prove to be a valuable option for reducing death and disability in SSA.