Risk factors profile and outcomes of stroke in low resources settings: a prospective and multicentric study in a sub-Saharan Africa country

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Introduction Stroke is a leading cause of mortality and disability worldwide, with a disproportionate burden in low- and middle-income countries. In sub-Saharan Africa, stroke occurs at younger ages, is characterized by a high proportion of hemorrhagic stroke, and is associated with poorer clinical outcomes. This study aimed to describe the risk factors, stroke subtypes, and clinical outcomes of patients admitted to tertiary hospitals in Luanda, Angola. Methods A prospective, observational, multicenter cohort study was conducted including patients diagnosed with ischemic or hemorrhagic stroke who were admitted between May and October 2024 to three tertiary hospitals in Luanda, including two public and one private hospital. Functional outcomes were assessed using the modified Rankin Scale at hospital discharge and at 30, 60, and 90 days. Statistical significance was set at p < 0.05. Results A total of 165 patients were included, with a mean age of 57.1 ± 13.5 years, and 55.7% of them were younger than 60 years. Males accounted for 52.1% of the sample. Ischemic stroke was the most common subtype, although hemorrhagic stroke represented 46% of cases. Hypertension (84.4%) and sedentary lifestyle (81.8%) were the most prevalent risk factors. At hospital discharge, 18% of patients were functionally independent, whereas 77% had functional dependence. Overall 90-day mortality was 13.3% (22/165), including 4.8% (8/165) in-hospital mortality and 8.5% (14/165) post-discharge mortality during follow-up. Conclusion In this cohort, stroke occurred at younger ages and was associated with a high proportion of hemorrhagic stroke, substantial functional dependence, and significant mortality. Hypertension was the main modifiable risk factor. These findings reinforce the need for effective primary prevention strategies, as well as improved screening and control of hypertension in Angola.

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