Fred Stephen Sarfo1, Bruce Ovbiagele2, Onoja Akpa Matthew3, Albert Akpalu4, Kolawole Wahab5, Reginald Obiako6, Lukman Owolabi7, Osahon Asowata3, Godwin Ogbole8, Morenikeji Komolafe9, Rufus Akinyemi10, Mayowa Owolabi11. 1. Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Electronic address: stephensarfo78@gmail.com. 2. Weill Institute for Neurosciences, School of Medicine, University of California San-Francisco, USA. 3. Department of Epidemiology and Medical Statistics, Institute of Cardiovascular Diseases, College of Medicine, University of Ibadan, Nigeria. 4. Department of Medicine, University of Ghana Medical School, Accra, Ghana. 5. Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria. 6. Department of Medicine, Ahmadu Bello University, Zaria, Nigeria. 7. Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria. 8. Department of Radiology, University of Ibadan, Nigeria. 9. Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria. 10. Federal Medical Centre, Abeokuta, Nigeria; Department of Medicine, University of Ibadan, Nigeria. 11. Department of Medicine, University of Ibadan, Nigeria.
Abstract
BACKGROUND: Acute infections have been posited as potential precipitants or triggers of the occurrence of stroke among adults with traditional vascular risk factors. We evaluated associations between stroke occurrence and reported febrile illness within 4 weeks (potential antecedent infections) 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. Cases include adults aged ≥18 years with radiologically confirmed strokes. Controls were stroke-free adults matched with cased by age, gender and ethnicity. Detailed evaluations for vascular, lifestyle and psychosocial factors were performed. Participants were asked for evidence of any febrile illness within the past 4 weeks. We used conditional logistic regression to estimate adjusted odds ratios (aOR) with 95% Confidence Interval. RESULTS: Among 3588 stroke cases recruited in Ghana and Nigeria between August 2014 and July 2018, 363 cases (10.1%) reported having a febrile illness within the 4 weeks prior to stroke occurrence. Having an antecedent infection was associated with stroke occurrence with an unadjusted OR of 1.19 (1.00-1.51) but aOR of 0.83 (0.59-1.17) upon adjusting for traditional vascular risk factors. Stress, aOR of 4.69 (2.59-8.50) and consumption of green vegetables 2.27 (1.35-2.85) were associated with antecedent febrile illness. CONCLUSION: 1 in 10 stroke cases reported antecedent history of febrile illness prior to occurrence of stroke but no independent association was observed in this study. Infectious exposures may be important triggers of cardiovascular events requiring further exploratory studies to better understand the role of this emerging risk factor.
BACKGROUND: Acute infections have been posited as potential precipitants or triggers of the occurrence of stroke among adults with traditional vascular risk factors. We evaluated associations between stroke occurrence and reported febrile illness within 4 weeks (potential antecedent infections) 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. Cases include adults aged ≥18 years with radiologically confirmed strokes. Controls were stroke-free adults matched with cased by age, gender and ethnicity. Detailed evaluations for vascular, lifestyle and psychosocial factors were performed. Participants were asked for evidence of any febrile illness within the past 4 weeks. We used conditional logistic regression to estimate adjusted odds ratios (aOR) with 95% Confidence Interval. RESULTS: Among 3588 stroke cases recruited in Ghana and Nigeria between August 2014 and July 2018, 363 cases (10.1%) reported having a febrile illness within the 4 weeks prior to stroke occurrence. Having an antecedent infection was associated with stroke occurrence with an unadjusted OR of 1.19 (1.00-1.51) but aOR of 0.83 (0.59-1.17) upon adjusting for traditional vascular risk factors. Stress, aOR of 4.69 (2.59-8.50) and consumption of green vegetables 2.27 (1.35-2.85) were associated with antecedent febrile illness. CONCLUSION: 1 in 10 stroke cases reported antecedent history of febrile illness prior to occurrence of stroke but no independent association was observed in this study. Infectious exposures may be important triggers of cardiovascular events requiring further exploratory studies to better understand the role of this emerging risk factor.
Authors: Fred S Sarfo; John Akassi; Dominic Awuah; Sheila Adamu; Clara Nkyi; Mayowa Owolabi; Bruce Ovbiagele Journal: J Neurol Sci Date: 2015-08-04 Impact factor: 3.181
Authors: Fred Stephen Sarfo; John Akassi; Sheila Adamu; Vida Obese; Bruce Ovbiagele Journal: J Stroke Cerebrovasc Dis Date: 2017-06-23 Impact factor: 2.136
Authors: Fred Stephen Sarfo; John Akassi; Sheila Adamu; Vida Obese; Manolo Agbenorku; Bruce Ovbiagele Journal: J Neurol Sci Date: 2020-06-05 Impact factor: 3.181
Authors: Fred Stephen Sarfo; Adetayo Kasim; Richard Phillips; Anna Maria Geretti; David R Chadwick Journal: J Infect Date: 2014-06-27 Impact factor: 6.072
Authors: John W Cole; David W Brown; Wayne H Giles; Oscar C Stine; Jeffrey R O'Connell; Braxton D Mitchell; John D Sorkin; Marcella A Wozniak; Barney J Stern; Mary J Sparks; Mark T Dobbins; Latasha T Shoffner; Nancy K Zappala; Laurie J Reinhart; Steven J Kittner Journal: Thromb J Date: 2008-08-26
Authors: Clara Ballerini; Alfred K Njamnshi; Sharon L Juliano; Rajesh N Kalaria; Roberto Furlan; Rufus O Akinyemi Journal: Front Immunol Date: 2022-06-13 Impact factor: 8.786