Clinical and neuroimaging factors associated with 30-day fatality among indigenous West Africans with spontaneous intracerebral hemorrhage.

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.

Patient-level and system-level determinants of stroke fatality across 16 large hospitals in Ghana and Nigeria: a prospective cohort study.

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.

Secondhand smoke exposure is independently associated with stroke among non-smoking adults in West Africa.

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.

Risk Factor Characterization of Ischemic Stroke Subtypes Among West Africans.

Background And Purpose: To identify the qualitative and quantitative contributions of conventional risk factors for occurrence of ischemic stroke and its key pathophysiologic subtypes among West Africans.

Methods: The SIREN (Stroke Investigative Research and Educational Network) is a multicenter, case-control study involving 15 sites in Ghana and Nigeria. Cases include adults aged ≥18 years with ischemic stroke who were etiologically subtyped using the A-S-C-O-D classification into atherosclerosis, small-vessel occlusion, cardiac pathology, other causes, and dissection.

A Novel Afrocentric Stroke Risk Assessment Score: Models from the Siren Study.

Background: Stroke risk can be quantified using risk factors whose effect sizes vary by geography and race. No stroke risk assessment tool exists to estimate aggregate stroke risk for indigenous African.

Objectives: To develop Afrocentric risk-scoring models for stroke occurrence.

Antenatal Dexamethasone for Early Preterm Birth in Low-Resource Countries.

Background: The safety and efficacy of antenatal glucocorticoids in women in low-resource countries who are at risk for preterm birth are uncertain.

Methods: We conducted a multicountry, randomized trial involving pregnant women between 26 weeks 0 days and 33 weeks 6 days of gestation who were at risk for preterm birth. The participants were assigned to intramuscular dexamethasone or identical placebo.

Arsenicosis in bladder pathology and schistosomiasis in Eggua, Nigeria.

Background: Chronic schistosomiasis and arsenic exposure through drinking water are some of the risk factors for bladder cancer. To determine the association of schistosomiasis and arsenicosis with bladder pathologies, 122 individuals from Eggua in southwest Nigeria were recruited for this study.

Methods: Prevalence of schistosomiasis was determined by urine microscopy and PCR.

Metabolite profiling for biomarkers in Schistosoma haematobium infection and associated bladder pathologies.

Background: Metabolic fingerprinting analysis can offer insights into underlying reactions in a biological system; hence it is crucial to the understanding of disease pathogenesis and could provide useful tools for discovering biomarkers. We sought to examine the urine and plasma metabolome in individuals affected by urogenital schistosomiasis and its associated-bladder pathologies.

Methodology: Blood and midstream urine were obtained from volunteers who matched our inclusion criteria among residents from Eggua, southwestern Nigeria.

Correction: The microbiome in urogenital schistosomiasis and induced bladder pathologies.

[This corrects the article DOI: 10.1371/journal.pntd.

The microbiome in urogenital schistosomiasis and induced bladder pathologies.

Background: Human schistosomiasis is a highly prevalent neglected tropical disease (NTD) caused by Schistosoma species. Research on the molecular mechanisms influencing the outcomes of bladder infection by Schistosoma haematobium is urgently needed to develop new diagnostics, therapeutics and infection prevention strategies. The objective of the research study was to determine the microbiome features and changes in urine during urogenital schistosomiasis and induced bladder pathologies.

Prevalence and Prognostic Features of ECG Abnormalities in Acute Stroke: Findings From the SIREN Study Among Africans.

Background: Africa has a growing burden of stroke with associated high morbidity and a 3-year fatality rate of 84%. Cardiac disease contributes to stroke occurrence and outcomes, but the precise relationship of abnormalities as noted on a cheap and widely available test, the electrocardiogram (ECG), and acute stroke outcomes have not been previously characterized in Africans.

Objectives: The study assessed the prevalence and prognoses of various ECG abnormalities among African acute stroke patients encountered in a multisite, cross-national epidemiologic study.

Phenotyping Stroke in Sub-Saharan Africa: Stroke Investigative Research and Education Network (SIREN) Phenomics Protocol.

Background: As the second leading cause of death and the leading cause of adult-onset disability, stroke is a major public health concern particularly pertinent in Sub-Saharan Africa (SSA), where nearly 80% of all global stroke mortalities occur, and stroke burden is projected to increase in the coming decades. However, traditional and emerging risk factors for stroke in SSA have not been well characterized, thus limiting efforts at curbing its devastating toll. The Stroke Investigative Research and Education Network (SIREN) project is aimed at comprehensively evaluating the key environmental and genomic risk factors for stroke (and its subtypes) in SSA while simultaneously building capacities in phenomics, biobanking, genomics, biostatistics, and bioinformatics for brain research.

Body mass index as a determinant of carotid intima-media thickness in Nigerian adults with primary hypertension.

Background: Long standing hypertension may result in thickening of arterial walls and is reportedly strongly correlated with body mass index (BMI). B-mode ultrasound is a reproducible method for evaluating adaptive vascular changes. The aim of this study is to determine the relationship between body mass index and ultrasound measured carotid intima-media thickness (CIMT) among adults with primary hypertension.

Exploring carotid sonographic parameters associated with stroke risk among hypertensive stroke patients compared to hypertensive controls.

Objectives: Globally, and particularly in low- and middle-income countries, the prevalence of hypertension is increasing with a consequent rise in the burden of stroke. There is a need to identify biomarkers of stroke, which can be used to design stroke prevention programs in these populations. Sonography is an affordable and widely available imaging modality that is ideal for resource-poor countries.

Which risk factors are more associated with ischemic rather than hemorrhagic stroke in black Africans?

Objective: To comprehensively examine the relationship of vascular risk factors to stroke type in native black Africans.

Methods: We explored 34 candidate demographic, clinical, and laboratory variables in 282 consecutive adult stroke patients with brain imaging.

Results: Ischemic stroke (IS) was found in 61.

The relationship of flow velocities to vessel diameters differs between extracranial carotid and vertebral arteries of stroke patients.

Background: Chronic changes in flow rate through arteries produce adjustment of arterial diameters. We compared the relationship between flow velocity and diameter in the carotid and in the vertebral arteries of stroke patients.

Methods: Using triplex ultrasonography, the internal diameter and flow velocities of the common carotid, internal carotid, and vertebral arteries of 176 consecutive stroke patients were measured.

The role of routine post-natal abdominal ultrasound for newborns in a resource-poor setting: a longitudinal study.

Background: Neonatal abdominal ultrasound is usually performed in Nigeria to investigate neonatal symptoms rather than as a follow up to evaluate fetal abnormalities which were detected on prenatal ultrasound. The role of routine obstetric ultrasonography in the monitoring of pregnancy and identification of fetal malformations has partly contributed to lowering of fetal mortality rates. In Nigeria which has a high maternal and fetal mortality rate, many pregnant women do not have ante-natal care and not infrequently, women also deliver their babies at home and only bring the newborns to the clinics for immunization.

Abdominal ultrasonography in HIV/AIDS patients in southwestern Nigeria.

Background: Though the major target of the HIV-virus is the immune system, the frequency of abdominal disorders in HIV/AIDS patients has been reported to be second only to pulmonary disease. These abdominal manifestations may be on the increase as the use of antiretroviral therapy has increased life expectancy and improved quality of life. Ultrasonography is an easy to perform, non invasive, inexpensive and safe imaging technique that is invaluable in Africa where AIDS is most prevalent and where sophisticated diagnostic tools are not readily available.