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Estimating the uptake of brain imaging and 30-days stroke mortality in Nigeria : a meta-analysis of hospital-based studies
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Ezejimofor, Martinsixtus C., Biu, Amabetare and Uthman, Olalekan A. (2018) Estimating the uptake of brain imaging and 30-days stroke mortality in Nigeria : a meta-analysis of hospital-based studies. Journal of the Neurological Sciences, 394 . pp. 6-13. doi:10.1016/j.jns.2018.08.022 ISSN 0022-510X.
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WRAP-estimating-uptake-brain-imaging-days-stroke-Uthman-2018.pdf - Accepted Version - Requires a PDF viewer. Download (3566Kb) | Preview |
Official URL: http://dx.doi.org/10.1016/j.jns.2018.08.022
Abstract
Purpose
This study aims to estimate the computed tomography (CT) and Magnetic resonance imaging (MRI) uptake, stroke subtypes and 30-days case-fatality in Nigeria.
Methods
Stroke diagnosis and mortality data were identified from relevant databases. A random effect meta-analysis was conducted to obtain the pooled percentage uptake of CT/MRI, including 30-days case fatality and a meta-regression-like epidemiological model was applied on all data points.
Findings
A total of 24 studies involving 5874 stroke patients conducted in predominantly tertiary referral hospitals met the inclusion criteria. The pooled CT/MRI uptake in the last seven years was 46.66% (95% CI = 15.35 to 77.98, 8 studies). There were significant variations in the prevalence of stroke subtypes. The pooled prevalence ischemic stroke was highest (55.32%, 95% CI 48.67 to 61.97, 16 studies), followed by intracerebral haemorrhage (ICH) (32.69%, 95% CI 25.54 to 39.83, 16 studies), subarachnoid haemorrhage (SAH) (3.76%, 95% CI 2.30 to 5.22, 14 studies). In addition, the stroke of undetermined aetiology was found to be 16.57% (95% CI, 7.44–25.70, 8 studies). Overall, the 24-h, one-week and 30-days case-fatality from stroke were 10.84% (95% CI, 4.48–17.20), 24.62% (95% CI, 17.20–32.04) and 33.28% (95% CI, 27.80–38.77), respectively. There was a moderate negative correlation between prevalence of brain imaging uptake and ischaemic stroke, albeit not statistically significant (Spearman rho = 0.333, p-value = .412).
Conclusion
Uptake of CT/MRI procedure for stroke is poor in Nigeria. Although poverty, inaccessibility and influence of major risk factors remain pronounced, scaling up of effective strategies for stroke prevention and management should be a major public health policy priority in Nigeria.
| Item Type: | Journal Article | ||||||||
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | Journal of the Neurological Sciences | ||||||||
| Publisher: | Elsevier BV | ||||||||
| ISSN: | 0022-510X | ||||||||
| Official Date: | 15 November 2018 | ||||||||
| Dates: |
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| Volume: | 394 | ||||||||
| Page Range: | pp. 6-13 | ||||||||
| DOI: | 10.1016/j.jns.2018.08.022 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||||
| Date of first compliant deposit: | 29 August 2018 | ||||||||
| Date of first compliant Open Access: | 24 August 2019 |
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