Recurrent Stroke in University Neurology Departments in Lomé (Togo, West Africa) in 2023-2024
Abstract
Kossivi Apetse*, Alois Franklin Mondonga Issey, Achraf Adou Rahim Alimi, Komla Nyinevi Anayo, Abide Talabewui, Kodjo Agbeko Djagadou, Kokou Mensah Guinhouya, Komi Assogba, Mofou Belo and Agnon Ayelola Koffi Balogou
Introduction: Recurrent strokes are common and account for a significant proportion of the high morbidity and mortality rates associated with strokes worldwide. In Togo, where stroke remains a public health problem, we have no data on recurrent stroke. The aim of this study is to describe the frequency, subtypes, time to onset, and short-term progression of recurrent stroke in hospitals in Togo.
Methods: This is a series of 174 cases of recurrent stroke collected in the neurology departments of university hospitals in Lomé from January 2023 to April 2024. The diagnosis of stroke was made clinically and confirmed by brain imaging. The interview, follow-up records, and hospital medical records were used to characterize previous strokes and recurrences.
Results: Recurrences accounted for 9.8% of strokes. The average age of patients was 62.67 +/- 12.67 years, with a predominance of males (54%). The time to recurrence was 12 months in 65.5% of patients. The last stroke was ischemic in 84% of patients, 6.2% of whom had good compliance with antithrombotic therapy. The last follow-up neurology consultation was 3 to 6 months ago in 65% of patients. The ischemic subtype accounted for 78% of recurrences. Death occurred in 13.2% of patients. The factors contributing to recurrence were dominated by treatment discontinuation and, in some cases, inadequate secondary prevention treatment.
Conclusion: Most stroke recurrences are ischemic and occur in the context of non-compliance with secondary prevention treatment. Therapeutic education could help reduce the incidence of stroke recurrence.