Publications by authors named "Onoja Akpa"

Article Synopsis
  • 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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Hypertension is a major risk factor for cardiovascular events worldwide, and little is known about its association with sleep quality (SQ) among Africans. We evaluated the association of SQ with hypertension among adults in Ibadan, Nigeria. In Ibadan and its suburbs, we identified 3635 participants in the door-to-door Community-based Investigation of the Risk Factors for Cardiovascular Diseases (COMBAT-CVDs) study.

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Background: The sleep quality scale (SQS) is a comprehensive multidimensional sleep assessment scale used to evaluate sleep quality (SQ) among adults in the general population. However, the scale is yet to be validated among indigenous African populations such as in Nigeria. This study validated the factor structure and evaluated the reliability of a previously developed SQS among community-based adults in Ibadan, Nigeria.

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Background: Prediction algorithms/models are viable methods for identifying individuals at high risk of stroke across diverse populations for timely intervention. However, evidence summarizing the performance of these models is limited. This study examined the performance and weaknesses of existing stroke risk-score-prediction models (SRSMs) and whether performance varied by population and region.

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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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Article Synopsis
  • 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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Purpose: Sleep quality (SQ) is essential in the overall well-being and quality of life, but little is known about the association of secondhand smoking (SHS) with SQ. This study assessed the relationship between SHS and SQ among adults who had never smoked in Ibadan, Nigeria.

Methods: We identified 3193 respondents who had never smoked or used any form of tobacco product in the Community-based Investigation of the Risk Factors for Cardiovascular Diseases in the Ibadan and suburbs (COMBAT-CVDs) study.

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Primary open-angle glaucoma (POAG), the leading cause of irreversible blindness worldwide, disproportionately affects individuals of African ancestry. We conducted a genome-wide association study (GWAS) for POAG in 11,275 individuals of African ancestry (6,003 cases; 5,272 controls). We detected 46 risk loci associated with POAG at genome-wide significance.

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Background: The dietary factors associated with the high burden of hypertension among indigenous Africans remain poorly understood. We assessed the relationship between dietary patterns and hypertension among indigenous Africans.

Method: In this study, 1550 participants with hypertension matched (for age: ± 5 years, sex and ethnicity) with 1550 participants without hypertension were identified from the stroke-free population in the Stroke Investigative Research and Educational Network study in Ghana and Nigeria.

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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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Article Synopsis
  • The study explored how diagnosed high blood pressure (HBP) relates to closeness to healthcare and noise sources in Ibadan, Nigeria, focusing on various sociodemographic and economic factors.
  • Researchers analyzed data from 13,531 adults using GIS to map locations of key community facilities and health diagnoses, finding significant links between HBP and proximity to pharmacies, religious institutions, and major roads.
  • The findings revealed that being unemployed, married, and having higher educational levels increased the odds of having diagnosed HBP, suggesting that reducing noise pollution might help lower hypertension rates in urban areas.
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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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  • The study investigates the role of cerebrovascular disease in HIV-associated neurocognitive disorder (HAND) among a specific black population in Nigeria, comparing participants with and without cognitive impairments using CT perfusion imaging.
  • It involved 27 HIV+ adults divided into impaired (18) and unimpaired (9) groups, measuring brain blood flow and volume across key regions, and found significant differences in regional blood flow variability between the two groups.
  • The findings suggest that CT perfusion imaging can effectively show cerebral perfusion changes linked to HAND, highlighting its potential as a resource for addressing HIV impacts in Africa, where the epidemic is most severe.
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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: 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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  • A study aimed to evaluate community-dwelling adults in Nigeria regarding their knowledge of stroke risks and their willingness to use mobile health (mHealth) technology to assess those risks.
  • Conducted with 486 participants, it revealed 84% were interested in knowing their stroke risk; however, only 29.6% had previously had their risk assessed, with a preference for immediate risk information over longer-term predictions.
  • The findings suggest a strong interest in using mHealth applications for stroke risk assessment, highlighting the need for clinical trials to explore this as a prevention strategy in sub-Saharan Africa.
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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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  • A pilot randomized controlled trial tested a mobile health intervention aimed at improving stroke risk awareness and control in 100 stroke-free adults with multiple vascular risk factors in Africa.
  • Participants were divided into a control group receiving brief counseling and an intervention group using a stroke video and a riskometer app for 2 months, resulting in a significant improvement in stroke risk scores and awareness in the intervention group.
  • The study showed promising outcomes in reducing stroke risk and blood pressure, suggesting a need for further research with longer follow-up to evaluate the effectiveness of such interventions.
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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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