Fred S Sarfo1, Patrick Berchie2, Arti Singh3, Michelle Nichols4, Maria Agyei-Frimpong5, Carolyn Jenkins4, Bruce Ovbiagele6. 1. Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana. Electronic address: stephensarfo78@gmail.com. 2. Medical University of South Carolina, Charleston, South Carolina. 3. Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 4. Northern California Institute of Research & Education, California. 5. Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana. 6. University of California, San Francisco, California.
Abstract
BACKGROUND AND PURPOSE: Poststroke fatigue (PSF) is rife among stroke survivors and it exerts a detrimental toll on recovery from functional deficits. The burden of PSF is unknown in sub-Saharan Africa. We have assessed the prevalence, trajectory, and predictors of PSF among 60 recent Ghanaian stroke patients. METHODS: Study participants in this prospective cohort (recruited between January 2017 and June 2017) were stroke survivors, aged greater than 18 years, with CT scan confirmed stroke of less than 1-month onset. PSF was assessed using the Fatigue Severity Scale (FSS) at enrollment, months 3, 6, and 9. Those with a score of greater than or equal to 4 points on FSS were categorized as "fatigued." A multivariate logistic regression analysis was performed to identify independent predictors of PSF at enrollment and at month 9. RESULTS: Sixty-five percent (65%) of our sample were males with a mean age of 55.1 ± 12.7 years. In addition to all participants having hypertension, 85% had dyslipidemia and 25% had diabetes mellitus. Ischemic strokes comprised 76.6% of the study population. The prevalence of PSF was 58.9% at baseline and declined to 23.6% at month 9, P = .0002. Diabetes mellitus was significantly associated with PSF at baseline with an adjusted odds ratio of 15.12 (95% CI: 1.70-134.30), P = .01. However, at month 9, age greater than or equal to 65 years, adjusted odds ratio (aOR) of 7.02 (95% CI: 1.16-42.52); female sex, aOR of 8.52 (1.23-59.16), and depression, aOR of 8.86 (1.19-65.88) were independently associated with PSF. CONCLUSIONS: Approximately 6 out of 10 Ghanaian stroke survivors experience PSF within the first month of stroke onset. PSF persists in approximately 1 out of 4 stroke survivors at 10 months after the index stroke. Further studies to elucidate the underlying mechanisms for PSF are required and adequately powered interventional multicenter trials are eagerly awaited to provide solid evidence base for the clinical management of PSF.
BACKGROUND AND PURPOSE:Poststroke fatigue (PSF) is rife among stroke survivors and it exerts a detrimental toll on recovery from functional deficits. The burden of PSF is unknown in sub-Saharan Africa. We have assessed the prevalence, trajectory, and predictors of PSF among 60 recent Ghanaian strokepatients. METHODS: Study participants in this prospective cohort (recruited between January 2017 and June 2017) were stroke survivors, aged greater than 18 years, with CT scan confirmed stroke of less than 1-month onset. PSF was assessed using the Fatigue Severity Scale (FSS) at enrollment, months 3, 6, and 9. Those with a score of greater than or equal to 4 points on FSS were categorized as "fatigued." A multivariate logistic regression analysis was performed to identify independent predictors of PSF at enrollment and at month 9. RESULTS: Sixty-five percent (65%) of our sample were males with a mean age of 55.1 ± 12.7 years. In addition to all participants having hypertension, 85% had dyslipidemia and 25% had diabetes mellitus. Ischemic strokes comprised 76.6% of the study population. The prevalence of PSF was 58.9% at baseline and declined to 23.6% at month 9, P = .0002. Diabetes mellitus was significantly associated with PSF at baseline with an adjusted odds ratio of 15.12 (95% CI: 1.70-134.30), P = .01. However, at month 9, age greater than or equal to 65 years, adjusted odds ratio (aOR) of 7.02 (95% CI: 1.16-42.52); female sex, aOR of 8.52 (1.23-59.16), and depression, aOR of 8.86 (1.19-65.88) were independently associated with PSF. CONCLUSIONS: Approximately 6 out of 10 Ghanaian stroke survivors experience PSF within the first month of stroke onset. PSF persists in approximately 1 out of 4 stroke survivors at 10 months after the index stroke. Further studies to elucidate the underlying mechanisms for PSF are required and adequately powered interventional multicenter trials are eagerly awaited to provide solid evidence base for the clinical management of PSF.
Authors: Fred Stephen Sarfo; Manolo Agbenorku; Sheila Adamu; Vida Obese; Patrick Berchie; Bruce Ovbiagele Journal: J Neurol Sci Date: 2019-07-23 Impact factor: 3.181
Authors: Fred Stephen Sarfo; Linda Meta Mobula; Titus Adade; Yvonne Commodore-Mensah; Martin Agyei; Collins Kokuro; Rexford Adu-Gyamfi; Christiana Duah; Bruce Ovbiagele Journal: J Neurol Sci Date: 2020-03-04 Impact factor: 3.181
Authors: Fred Stephen Sarfo; Rufus Akinyemi; George Howard; Virginia J Howard; Kolawole Wahab; Mary Cushman; Deborah A Levine; Adesola Ogunniyi; Fred Unverzagt; Mayowa Owolabi; Bruce Ovbiagele Journal: J Neurol Sci Date: 2020-02-19 Impact factor: 4.553