Publications by authors named "Akpalu A"

Introduction: The prevalence of epilepsy in sub-Saharan Africa varies considerably, and the exact estimate for Ghana remains unclear, particularly in peri-urban areas where data are scarce. More community-based studies are required to understand better the actual burden of epilepsy in these areas and the difficulties in accessing healthcare.

Objective: To adapt and validate a household survey epilepsy-screening instrument in Shai-Osudoku and Ningo-Prampram District of Greater Accra Region, Ghana.

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Introduction: Epilepsy is a prevalent neurological condition globally, especially in Sub-Saharan Africa. In Ghana, it is one of the top five causes of premature death and disability, impacting children's neurological development and learning outcomes. Although 25% of epilepsy cases are preventable, many go undiagnosed and untreated.

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  • The study aimed to investigate how alcohol consumption is linked to stroke occurrences in Nigeria and Ghana by comparing individuals who had strokes to those who didn't.!
  • It involved over 7,368 participants, classifying them into groups based on their alcohol consumption habits, and utilized various statistical models to analyze the data.!
  • Results indicated that current drinkers had a higher risk of stroke, particularly among moderate, binge, and heavy drinkers, while former drinkers showed no significant stroke risk. !
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Objective: To document the location, size, and multiplicity of intracranial aneurysms in Ghanaians who have undergone digital subtraction angiography (DSA) at a single centre in Accra, Ghana.

Design: We conducted a retrospective observational review of the medical records of all patients diagnosed with intracranial aneurysms on DSA.

Setting: Patients' medical records at Euracare Advanced Diagnostic and Heart Centre were reviewed between March 2018 and March 2020.

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Parkinson's disease (PD) is a progressive and disabling neurodegenerative disease that rapidly worsens and results in premature mortality if left untreated. Although levodopa is the gold standard treatment for PD globally, its accessibility and affordability are severely limited in low- and middle-income countries worldwide. In this scenario, Mucuna pruriens (MP), a leguminous plant growing wild in tropical regions, emerges as a potential alternative or adjunct to levodopa-based medications due to its cost-effectiveness and global natural availability.

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Background: Hypertension is preeminent among the vascular risk factors for stroke occurrence. The wide gaps in awareness, detection, treatment, and control rates of hypertension are fueling an epidemic of stroke in sub-Saharan Africa.

Purpose: To quantify the contribution of untreated, treated but uncontrolled, and controlled hypertension to stroke occurrence in Ghana and Nigeria.

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  • African ancestry populations have the highest stroke burden globally, yet the genetic factors contributing to stroke in these groups are not well understood, prompting the SIREN study in West Africa to investigate this.
  • The study involved recruiting stroke patients and stroke-free controls to conduct a genome-wide association study (GWAS), leading to DNA analysis that identified significant SNPs near specific genes associated with stroke risk.
  • Key findings highlighted protective genetic variants near AADACL2 and MIR5186 on chromosome 3, as well as other notable associations on chromosomes 5, 6, 12, 16, and 18, which could provide insights for future stroke risk assessment in these populations.
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Background: Frequent fruit and vegetable consumption is considered a promising dietary behaviour that protects health. However, most existing studies about the factors associated with this phenomenon among Africans are based on single-country reports, apart from one meta-regression combining smaller studies. This study harmonized large datasets and assessed factors associated with the frequency of fruit and vegetable consumption in this population.

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Background: Spontaneous intracerebral hemorrhage (ICH) is associated with a high case fatality rate in resource-limited settings. The independent predictors of poor outcome after ICH in sub-Saharan Africa remains to be characterized in large epidemiological studies. We aimed to determine factors associated with 30-day fatality among West African patients with ICH.

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  • Non-cigarette tobacco (NCT) use is linked to an increased risk of stroke among indigenous Africans, suggesting a need for better understanding and public health interventions.
  • The study involved 7,617 respondents, showing that those who used smokeless NCT had a significant association with stroke, while smoked NCT did not show a strong link.
  • Increased awareness and targeted policies are essential to address the rising burden of stroke related to NCT usage in the population.
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Background: There is a growing interest in stroke genomics and neurobiobanking research in Africa. These raise several ethical issues, such as consent, re-use, data sharing, storage, and incidental result of biological samples. Despite the availability of ethical guidelines developed for research in Africa, there is paucity of information on how the research participants' perspectives could guide the research community on ethical issues in stroke genomics and neurobiobanking research.

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Background: Parkinson's disease (PD) is the second most common neurodegenerative disorder and, according to the Global Burden of Disease estimates in 2015, was the fastest growing neurological disorder globally with respect to associated prevalence, disability, and deaths. Information regarding the awareness, diagnosis, phenotypic characteristics, epidemiology, prevalence, risk factors, treatment, economic impact and lived experiences of people with PD from the African perspective is relatively sparse in contrast to the developed world, and much remains to be learned from, and about, the continent.

Methods: Transforming Parkinson's Care in Africa (TraPCAf) is a multi-faceted, mixed-methods, multi-national research grant.

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Background: This study aimed to develop a risk-scoring model for hypertension among Africans.

Methods: In this study, 4413 stroke-free controls were used to develop the risk-scoring model for hypertension. Logistic regression models were applied to 13 risk factors.

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Objective: To identify the factors enabling and limiting family medicine (FM) programmes in Sub-Saharan Africa (SSA).

Design: A narrative review was conducted by searching a variety of databases. Papers focusing on the training, deployment, or contribution to healthcare systems of doctors with postgraduate training in FM in SSA, published in peer-reviewed journals from 2015 onwards and in English language were included.

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Introduction: The coronavirus disease 2019 (COVID-19) pandemic began at the end of 2019 in Wuhan, the capital of Hubei Province, China. This novel coronavirus is classified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Neurological manifestations are commonly associated with moderate to severe COVID-19 infection.

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  • Background research indicates that severe stroke outcomes in sub-Saharan Africa may be linked to initial stroke severity, but there is limited knowledge on what influences stroke severity specifically in indigenous Africans.
  • A study involving 3,660 West African stroke cases found that diet (high meat and low vegetable consumption) and lesion volume significantly correlated with severe stroke conditions, with severe cases comprising over half of all evaluated strokes.
  • The findings suggest that addressing dietary habits and understanding lesion characteristics could help mitigate the high rates of severe stroke in this population.
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Hypertension is a leading preventable and controllable risk factor for cardiovascular and cerebrovascular diseases and the leading preventable risk for death globally. With a prevalence of nearly 50% and 93% of cases uncontrolled, very little progress has been made in detecting, treating, and controlling hypertension in Africa over the past thirty years. We propose the African Control of Hypertension through Innovative Epidemiology and a Vibrant Ecosystem (ACHIEVE) to implement the HEARTS package for improved surveillance, prevention, treatment/acute care of hypertension, and rehabilitation of those with hypertension complications across the life course.

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Background: Every minute, six indigenous Africans develop new strokes. Patient-level and system-level contributors to early stroke fatality in this region are yet to be delineated. We aimed to identify and quantify the contributions of patient-level and system-level determinants of inpatient stroke fatality across 16 hospitals in Ghana and Nigeria.

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  • The study examined how stroke-free individuals and healthcare providers in Nigeria and Ghana perceive and prefer the disclosure of genetic testing results related to stroke.
  • Findings indicated that healthcare professionals generally had a better understanding of genetic testing compared to family members, and suggested that relatives and religious figures are preferred for delivering sensitive results to patients.
  • Challenges for effective disclosure included inadequate information, fear of stigma and familial distress, and a lack of awareness about national guidelines, highlighting the need for culturally tailored educational initiatives.
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Background: Stroke is a leading cause of disability and mortality worldwide, but little is known about the contribution of secondhand smoke exposure (SHSE) to stroke epidemiology among indigenous Africans.

Objective: To evaluate the association of SHSE with stroke among indigenous Africans.

Methods: We analyzed the relationship of SHSE with stroke among 2990 case-control pairs of adults who had never smoked (identified in the SIREN study) using conditional logistic regression at a two-sided P < 0.

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Background: There are limited data from Africa on the burden and associations between pre-diabetes (pre-DM), diabetes mellitus (DM) and stroke occurrence in a region experiencing a profound rise in stroke burden.

Purpose: To characterize the associations between stroke and dysglycemic status among West Africans.

Methods: The Stroke Investigative Research and Educational Network (SIREN) is a multicenter, case-control study involving 15 sites in Ghana and Nigeria.

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Aims: The relationship between vegetable consumption and hypertension occurrence remains poorly characterized in sub-Saharan Africa. This study assessed the association of vegetable consumption with odds of hypertension among indigenous Africans.

Methods And Results: We harmonized data on prior vegetable consumption and hypertension occurrence (defined as one of the following conditions; systolic blood pressure ≥140 or diastolic blood pressure ≥90 mmHg or previous diagnosis or use of antihypertensive medications) from 16 445 participants across five African countries (Nigeria, South Africa, Kenya, Ghana and Burkina Faso) in the Stroke Investigative Research and Educational Network and Africa Wits-INDEPTH partnership for Genomic studies.

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Background: We evaluated the characteristics of carotid and vertebral atherosclerosis in indigenous West Africans with stroke.

Methodology: Of the 3778stroke patients recruited between 01/2014 and 08/2017, 1070 (28.3%) received carotid and vertebral artery evaluation with B-mode Ultrasound.

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