Stroke Epidemiological Study at the Centre Hospitalier Universitaire (CHU) de Cocody in Abidjan, Côte D’Ivoire

Background: Recent literature reported a recurrent increase in hemorrhagic stroke (HS) rates in low- and middle-income countries. However, the causes and mechanisms of the rising HS rates are unknown. To address these issues, the present epidemiological study was carried out in the neurovascular unit of the neurology department at the Centre Hospitalier Universitaire (CHU) de Cocody in Abidjan (Africa). Methods: The study included 60 patients hospitalized from January 1 to December 31, 2016, who underwent brain CT (computerized tomography) scans. We examined the medical records and survey forms in these patients with acute stroke (within 7 days) admitted to the Neurovascular Unit receiving only stroke patients. In these patients, we explored stroke distribution according to socio-demographic variables: age, gender and socio-professional categories. In addition, common risk factors were assessed. Results: In Côte d’Ivoire, our studies showed an ischemic stroke (IS) rate of 66.67% and a hemorrhagic stroke (HS) rate of 33.33%. Our studies indicated that stroke particularly affects the 40 - 60 age group. Then, stroke frequency has fallen in the 30 - 40 and 60 - 70 age groups, becoming rare in relatively young (<20 years) and elderly (>70 years) subjects. In the sample analyzed, stroke occurred in women (56.67%) compared with men (43.33%). However, there was no gender-specific predilection for stroke. In addition, 90% of strokes occur in the working population and 10% in the non-working population. Arterial hypertension was the highest medical risk factor among patients (66.13%), compared with the other risk factors i.e. alcohol (17.42%), smoking (12.90%), previous stroke (9.67%), diabetes (6.65%), heart disease (6.65%) and dyslipidemia (3.23%). Specifically, hypertension was the main risk factor causing HS (45%) and IS (21.66%) in patients. Conclusion: Stroke particularly affected socio-economically active subjects (aged 40 - 60) in Africa, which were subjected to high prevalence of hemorrhagic stroke (HS). Chronic stress related to working life and unfavorable socioeconomic conditions would be a triggering event for hemorrhagic stroke.