NPR: Africa Is Suffering A Silent Crisis Of Stroke

The largest-ever study of stroke in Africa reveals how economic development is changing the picture of disease on the continent.

Courtesy Fredua Agyemang

Courtesy Fredua Agyemang

Last April, Fredua Agyemang, a musician in Kumasi, Ghana, was performing onstage at a funeral, which in this country is often a festive affair with hundreds of guests. Suddenly, he began to feel dizzy, then lost consciousness and collapsed.

When he woke up three days later, his bandmates broke the news: He had suffered a stroke. Immediately, he thought of another doctor visit eight years earlier, when, at the age of 34, he had been diagnosed with hypertension and prescribed medication to reduce his blood pressure. The medication had given him problems with erectile dysfunction, a common side effect, and he soon stopped taking it regularly. That decision seemed foolish, he recalls. He was having difficulty moving and speaking and knew that he wouldn't be back onstage anytime soon.

"I still have weakness," he says, nine months later. "I'm not able to walk well, I can't use my left arm, I can't sing."

Doctors found that Agyemang's stroke was hemorrhagic, meaning that a blood vessel in his brain burst from excessive pressure. In the U.S., this type of stroke is rare; nearly 90 percent of strokes in the U.S. are "ischemic," meaning they're caused by a clot or other blockage of a blood vessel in the brain. But according to a new study, the largest-ever of stroke patients in Africa, up to one-third of strokes in this area of the world are hemorrhagic. And while the survival rate for ischemic strokes is around 80 percent, for hemorrhagic strokes the odds of survival are only 50/50. Agyemang is lucky to be alive.

The study surveyed 2,000 stroke patients in Ghana and Nigeria (including Agyemang) to better understand what factors are most likely to put people at risk. The results were released Friday at the International Stroke Conference in Los Angeles and will be published next month in the peer-reviewed journal The Lancet.

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