Mayowa Owolabi

University of Ibadan

Background By 2050, the prevalence of dementia is projected to triple with the greatest increases anticipated in Africa and Asia – largely attributable to population growth and cardiometabolic disorder. Hand‐grip strength (HGS) is a known predictor of cardiometabolic and cognitive health. The relationship between HGS and cognitive impairment (CI) a...

Background The burden of Alzheimer’s disease and related dementias is growing fast in Africa. The Recruitment and Retention for Alzheimer’s Disease Diversity Genetic Cohorts in the Alzheimer’s Disease Sequencing Project (READD‐ADSP) has commenced recruitment of 5000 African participants (AD and cognitively unimpaired individuals) to generate genomi...

Background The “Recruitment and Retention for Alzheimer’s Disease Diversity Genetic Cohorts in the ADSP (READD‐ADSP)” is developing a resource to expand ancestral diversity in Alzheimer disease (AD) studies to dissect the genetic architecture of AD across different populations. In addition to US sites, READD‐ADSP includes four US sites and nine cou...

Acute ischemic stroke (AIS) is a known complication of Takayasu arteritis (TAK); however, it is infrequently the first symptom observed. There have been no reports of concomitant AIS and anterior ischemic optic neuropathy (AION) as an initial manifestation of TAK. We present a case of TAK causing stroke and painless vision loss in a young Nigerian...

BACKGROUND: Africans are affected by ICH at a relatively younger age than Caucasians, raising curiosity on the potential contribution of emerging risk factors such as lipoprotein-a [Lp(a)] to ICH in that population. We hypothesized that low serum Lipoprotein(a) [Lp(a)] could be an independent risk factor for ICH among Nigerian patients. METHODS N...

BACKGROUND: Indigenous Africans with earlier onset ICH and worse outcomes are grossly under-represented in studies exploring the potential contribution of serum lipoprotein(a) (Lp(a) to ICH fatality and outcome. We evaluated the relationship between Lp(a) and ICH outcome (fatality) among Nigerian patients. METHODS: N: 84 cases (first-ever ICH) +8...

BACKGROUND: Indigenous Africans with earlier onset ICH and worse outcomes are grossly under-represented in studies exploring the potential contribution of serum lipoprotein(a) (Lp(a) to ICH fatality and outcome. We evaluated the relationship between Lp(a) and ICH outcome (fatality) among Nigerian patients. METHODS: N: 84 cases (first-ever ICH)...

Background: Telerehabilitation as a new subdiscipline of telehealth is the application of information technology to support and deliver rehabilitation services via two-way or multipoint interactive online telecommunication technology. This enables the therapist to optimize the timing, intensity, and duration of therapy which is often not possible...

Background: Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditi...

Neurological conditions are the leading cause of death and disability combined. This public health crisis has become a global priority with the introduction of WHO's Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders 2022-2031 (IGAP). 18 months after this plan was adopted, global neurology stakeholders, including represen...

Background African ancestry populations have the highest burden of stroke worldwide, yet the genetic basis of stroke in these populations is obscure. The Stroke Investigative Research and Educational Network (SIREN) is a multicenter study involving 16 sites in West Africa. We conducted the first-ever genome-wide association study (GWAS) of stroke i...

Background Family planning is fundamental to women’s reproductive health and is a basic human right. Global targets such as Sustainable Development Goal 3 (specifically, Target 3.7) have been established to promote universal access to sexual and reproductive healthcare services. Country-level estimates of contraceptive use and other family planning...

Comment www.thelancet.com/lancetgh Vol 12 February 2024 e192 Priorities to reduce the burden of hypertension in Africa through ACHIEVE Hypertension is a leading cause of premature deaths in Africa. 1 Its prevalence of up to 54% in adults in Africa 2,3 is among the highest rates in the world. 4 More disturbingly, only 7% of individuals with hyperten...

Stroke in Africa

Neurorehabilitation

BACKGROUND: The disparity (in terms of prevalence) between ischemic and hemorrhagic stroke is rapidly being narrowed2-4. In sub-Saharan Africa, the prevalence of spontaneous intracerebral hemorrhage (ICH) is three times more than what obtains in western societies5. Hematoma volume is a known neuroimaging biomarker of primary injury and predictor o...

Background Sub-Saharan Africa (SSA) has experienced a surge of non-communicable diseases (NCDs) including chronic obstructive pulmonary disease (COPD) over the past two decades. Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), in this study we have estimated the burden and attributable risk factors of COPD acro...

Stroke is the second leading cause of death worldwide. The burden of disability after a stroke is also large, and is increasing at a faster pace in low-income and middle-income countries than in high-income countries. Alarmingly, the incidence of stroke is increasing in young and middle-aged people (ie, age <55 years) globally. Should these trends...

The relationship between serum LDL and Hemorrhagic Stroke (HS) severity was explored in a study population of indigenous Africans. Low baseline serum LDL showed an independent association with worse Glasgow Coma score at presentation. Optimal serum LDL levels does not translate to reduced severity of hemorrhagic stroke (HS) in indigenous Africans.

Reliable estimates of subnational vaccination coverage are critical to track progress towards global immunisation targets and ensure equitable health outcomes for all children. However, conflict can limit the reliability of coverage estimates from traditional household-based surveys due to an inability to sample in unsafe and insecure areas and inc...

Background Baseline stroke severity is probably partly responsible for poor stroke outcomes in sub‐Saharan Africa. However, there is a paucity of information on determinants of stroke severity among indigenous Africans. We sought to identify the factors associated with stroke severity among West Africans in the SIREN (Stroke Investigative Research...

The global burden of neurological disorders is substantial and increasing, especially in low-resource settings. The current increased global interest in brain health and its impact on population wellbeing and economic growth, highlighted in the World Health Organization's new Intersectoral Global Action Plan on Epilepsy and other Neurological Disor...

Background: Using tailored mobile health interventions to improve global vascular risk awareness and control is yet to be investigated for primary stroke prevention in Africa. Methods: This 2-arm pilot randomized controlled trial involved 100 stroke-free adults with at least 2 vascular risk factors for stroke. Eligible participants were assigned...

Background Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-res...

Background: Benign prostatic hyperplasia is a common urological disease affecting older men worldwide, but comprehensive data about the global, regional, and national burden of benign prostatic hyperplasia and its trends over time are scarce. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated global...

Stroke is the second leading cause of death and the third leading cause of disability worldwide and its burden is increasing rapidly in low-income and middle-income countries, many of which are unable to face the challenges it imposes. In this Health Policy paper on primary stroke prevention, we provide an overview of the current situation regardin...

Objectives: This study identified the predictors of weight reduction among adult obese patients in a Family Practice Setting and developed a statistical model to predict weight reduction. Design: A prospective cohort design. Setting: The Family Practice Clinic, University College Hospital, Ibadan, Nigeria. Participants and study tools: Obese...

Background: Contemporary data on stroke epidemiology and the availability of national stroke clinical registries are important for providing evidence to improve practice and support policy decisions. Aims: To update the most current incidence, case-fatality and mortality rates on stroke, and identify national stroke clinical registries worldwide. M...

Background: The fields of stroke genomics, biobanking, and precision medicine are rapidly expanding in sub-Saharan Africa. However, the ethical, legal, and social implications (ELSI) of emerging neurobiobanking and genomic data resources are unclear in an emerging African scientific landscape with unique cultural, linguistic, and belief systems. Ob...

We present here a unifying framework for affective phenomena: the Human Affectome. By synthesizing a large body of literature, we have converged on definitions that disambiguate the commonly used terms—affect, feeling, emotion, and mood. Based on this definitional foundation, and under the premise that affective states reflect allostatic concerns,...

Background Sub-Saharan Africa has the highest incidence, prevalence, and fatality from stroke globally. Yet, only little information about context-specific risk factors for prioritising interventions to reduce the stroke burden in sub-Saharan Africa is available. We aimed to identify and characterise the effect of the top modifiable risk factors fo...

Background Data on the burden and outcomes of recurrent strokes in sub-Saharan Africa are limited, impeding efforts at optimal recurrent stroke prevention. Objective To assess the prevalence, risk factor profile, stroke types and mortality from recurrent strokes in Ghana and Nigeria. Methods We analyzed data from 3553 stroke cases involved in the...

Low-resource settings lag behind the rest of the world in achieving good health, in part owing to poor translation of clinical evidence into practice. Focusing on neurological disorders — in particular, stroke — this Comment identifies barriers to translation at the individual, provider and health systems levels and proposes theory-driven mitigatin...

Hypertension is the leading preventable risk factor for cardiovascular diseases and disability globally. In low- and middle-income countries hypertension has a major social impact, increasing the disease burden and costs for national health systems. The present call to action aims to stimulate all African countries to adopt several solutions to ach...

Background Human resources for health (HRH) include a range of occupations that aim to promote or improve human health. The UN Sustainable Development Goals (SDGs) and the WHO Health Workforce 2030 strategy have drawn attention to the importance of HRH for achieving policy priorities such as universal health coverage (UHC). Although previous resear...

The Cardiometabolic Disorders in African-Ancestry Populations (CARDINAL) study site is a well-powered, first-of-its-kind resource for developing, refining and validating methods for research into polygenic risk scores that accounts for local ancestry, to improve risk prediction in diverse populations.

Background: The relationship of diet with stroke risk among Africans is not well understood. Aim: To investigate the association between dietary patterns and stroke risk among West Africans. Methods: In this multi-centre case-control study, 3684 stroke patients matched (for age and sex) with 3684 healthy controls were recruited from Nigeria and Gha...

The inaugural African Stroke Organization Conference (ASOC) aimed to create a forum to discuss the latest stroke science, highlight opportunities to address the high burden of stroke in Africa, develop a viable pipeline of emerging African stroke researchers, honor leading scientists and policy makers, and provide networking avenues to bolster futu...

Background and Aim Illicit substance use (ISU) is a public health problem and a prominent risk factor to morbidity and mortality worldwide. However, whether ISU contributes significantly to the escalating burden of stroke in sub-Saharan Africa is yet to be clearly understood. This study assessed the relationship between ISU and the risk of stroke a...

Background Sub-Saharan Africa (SSA) continues to have a high prevalence of stroke. While rapid advancements in genomic science, biobanking, and precision medicine provide insight and opportunities for targeted treatment advances, the ethical, legal, and social implications (ELSI) of stroke genomics and biobanking require further exploration. Metho...

Background & Aim Early identification and treatment of populations at risk of stroke in Africa have been delimited by the data to design a risk prediction model tailor-made for indigenous Africans. This study developed and tested an Afrocentric risk scoring model to predict stroke occurrence among West Africans. Method 7066 case-control pairs (ide...

Background and Aims Several studies have reported the relationship of diets to various diseases, but evidence for the true relationship between the consumption of green leafy vegetables and ischemic stroke (IS) or coronary artery diseases (CAD) is relatively limited. This study assessed the true association between higher consumption of green leafy...

Background The relationship between serum LDL level and hemorrhagic stroke is inconclusive. Several epidemiological Studies have noted that low LDL is a risk factor for ICH, however very few studies have defined the link between LDL and hemorrhagic stroke severity. Aim We hypothesized that low serum LDL levels may have association with intracerebr...

Introduction There is an urgent need to reduce the burden of non-communicable diseases (NCDs), particularly in low-and middle-income countries, where the greatest burden lies. Yet, there is little research concerning the specific issues involved in scaling up NCD interventions targeting low-resource settings. We propose to examine this gap in up to...

Objectives To use data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) to estimate mortality and disability trends for the population aged ≥70 and evaluate patterns in causes of death, disability, and risk factors. Design Systematic analysis. Setting Participants were aged ≥70 from 204 countries and terri...

Importance: The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. Objective: To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic...

For more than a year, the SARS-CoV-2 pandemic has had a devastating effect on global health. High-, low, and middle-income countries are struggling to cope with the spread of newer mutant strains of the virus. Delivery of acute stroke care remains a priority despite the pandemic. In order to maintain the time-dependent processes required to optimiz...

Stroke is the second leading cause of death and the third leading cause of disability worldwide and its burden is increasing rapidly in low-income and middle-income countries, many of which are unable to face the challenges it imposes. In this Health Policy paper on primary stroke prevention, we provide an overview of the current situation regardin...

Background: Improving stroke services is critical for reducing the global stroke burden. The World Stroke Organization-World Health Organization-Lancet Neurology Commission on Stroke conducted a survey of the status of stroke services in low and middle-income countries (LMICs) compared to high-income countries. Methods: Using a validated World Stro...

The stroke burden continues to grow across the globe, disproportionally affecting developing countries. This burden cannot be effectively halted and reversed without effective and widely implemented primordial and primary stroke prevention measures, including those on the individual level. The unprecedented growth of smartphone and other digital te...

Stroke exerts a tremendous burden on individuals, families, communities, and health systems globally. Even more troublesome are the striking disparities faced across diverse populations. These disparities are further exacerbated by the COVID-19 pandemic. Despite efforts to advance stroke research, substantial gaps remain in understanding factors th...

Introduction: Second-hand smoking (SHS) is an emerging phenomenon in cardiovascular disease (CVD) epidemiology, but whether SHS is associated with stroke is not clearly understood. We assessed the association between SHS and stroke risk in a cohort of West Africans in the Stroke Investigative Research and Educational Network (SIREN) study. Hypothes...

Introduction: High blood pressure is a prominent risk factor for stroke in Sub-Saharan Africa (SSA) where dietary factors associated with blood pressure are often under-reported. Hypothesis: Dietary patterns (DP) are not associated with systolic blood pressure (SBP) and diastolic blood pressure (DBP) among stroke-free Africans from Ghana and Nigeri...

Background: Given the projected trends in population ageing and population growth, the number of people with dementia is expected to increase. In addition, strong evidence has emerged supporting the importance of potentially modifiable risk factors for dementia. Characterising the distribution and magnitude of anticipated growth is crucial for publ...

Stroke is the second leading cause of death and the third leading cause of disability worldwide and its burden is increasing rapidly in low-income and middle-income countries, many of which are unable to face the challenges it imposes. In this Health Policy paper on primary stroke prevention, we provide an overview of the current situation regardin...

Background Given the projected trends in population ageing and population growth, the number of people with dementia is expected to increase. In addition, strong evidence has emerged supporting the importance of potentially modifiable risk factors for dementia. Characterising the distribution and magnitude of anticipated growth is crucial for publi...

Virtual Reality (VR) is an emerging neuroergonomics tool for stroke rehabilitation. It can be employed to promote post-stroke recovery during rehabilitation as a result of its neuroplasticity enhancing effects. This study systematically reviewed and meta-synthesised evidence on the effectiveness of virtual reality on selected markers of neuroplasti...

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15–39 years) are lacking. To address this...

Stroke is a major cause of death in Sub-Saharan Africa (SSA) and genetic factors appear to play a part. This led to the development of stroke bio-banking and genomics research in SSA. Existing stroke studies have focused on causes, incidence rates, fatalities and effects. However, scant attention has been paid to the legal issues about stroke bio-b...

Introduction. Reports continue to show that a significant association exists between serum vitamin D level and metabolic syndrome (MS)-associated inflammation. However, information on the serum levels of vitamin D and alterations in inflammation in different vitamin D status is presently lacking. Aim. To determine the serum levels of vitamin D and...

Background: Cardiovascular disease reflects a major burden of non-communicable disease in Sub-Saharan Africa (SSA). Early detection and treatment of atrial fibrillation (AF), as a preventive measure against stroke, is currently not in the scope of the World Health Organization recommendation to reduce cardiovascular disease. Objective: We hypoth...

Background: This study is part of the Stroke Investigative Research and Educational Network (SIREN), the largest study of stroke patients in Africa to date, with computed tomography (CT) or magnetic resonance (MR) imaging data for each patient to confirm stroke. Prior imaging studies performed using high-field MR (!1.5T) have shown that white matte...

Objectives To explore the prevalence and risk factors of obesity among older adults from low- and middle-income countries (LMICs). Methods This is a secondary analysis of data obtained from the SIREN study through in-person interviews and measurements from healthy stroke-free older adults (≥60 years). Overweight/obesity was defined as body mass in...

BACKGROUND There is mounting evidence that Parkinson's disease causes significant disability and impairs health-related quality of life. However, this dimension has not been fully characterised, particularly among Africans. We examined the generic and disease-specific health related quality of life profiles of Nigerian Africans with Parkinson's dis...

For more than a year, the SARS-CoV-2 pandemic has had a devastating effect on global health. High-, low-, and middle-income countries are struggling to cope with the spread of newer mutant strains of the virus. Delivery of acute stroke care remains a priority despite the pandemic. In order to maintain the time-dependent processes required to optimi...

Background Stroke risk can be quantified using risk factors whose effect sizes vary by geography and race. No stroke risk assessment tool exists to estimate aggregate stroke risk for indigenous African. Objectives To develop Afrocentric risk-scoring models for stroke occurrence. Materials and Methods We evaluated 3533 radiologically confirmed Wes...

Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a...