Jurnal Internasional vol.12 issue 2 2022
African Journal of Emergency Medicine
Stroke in Djibouti

Jurnal Internasional vol.12 issue 2 2022
African Journal of Emergency Medicine
Stroke in Djibouti

Stroke, Djibouti, Khat
Epidemiology, Cardiovascular risk factors

Background: Stroke is a neurological emergency affecting both developed and developing countries. In Djibouti,
stroke is the fourth leading cause of death. Our objective was to describe the demographic, clinical, paraclinical
profile of stroke in Djibouti and identify the possible underlying risk factors.
Methods: We conducted a cross-sectional multicentre study carried out over a period of 6 months in the medical
services of the Soudano-Djibouti military hospital, the General Peltier hospital and the emergency department of
the National fund for social security health centre.
Results: A total of seventy patients were included. The mean age was 59.61 years with a male predominance
(sex ratio: 2.5) and a statistically significant female-related difference beyond the age of 60 years (p <10−3).
Cardiovascular risk factors were mainly hypertension (73%), khat chewing (64%) and tobacco use (50%). Khat
chewing and tobacco use were associated with a younger age of occurrence of stroke (p=0.020 and p=0.004,
respectively). Diabetes mellitus and hypercholesterolemia were found respectively in 30% and 19% of cases,
and were more associated with ischemic stroke. Coronary disease (11%), heart failure (3%) and obesity (4%)
(significantly associated with the female gender; p= 0,021) were less common. Motor deficits (94%) were the
most common clinical manifestations, followed by sensory deficits (51%) and alteration of consciousness (37%).
Stroke was ischemic in 61.5% of patients. The most affected territory in ischemic stroke was the territory of
the middle cerebral artery, and capsulo-thalamic involvement in haemorrhagic stroke which was significantly
associated with the alteration of consciousness(p=0,003).
Discussion: Stroke had primarily modifiable risk factors in Djiboutian patients dominated by high blood pressure,
tobacco use and khat chewing especially in the male population under the age of 60 years. These findings could
have implications on future preventive measures and a better approach to public health policy.

Mohamed AHMED NOUR, Saloua MRABET, Mouled ALI MAIDAL , Alya GHARBI , Youssef ABIDA, Amira SOUISSI , Amina GARGOURI , Imen KACEM, Amina NASRI , Riadh GOUIDER

https://doi.org/10.1016/j.afjem.2022.03.002

16 March 2022

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