Tuesday, 09 April 2019 17:20

Prevalence and pattern of stroke among patients attending a teaching hospital in Dhamar governorate, Yemen Featured

Original Research:

Mohammed Q. SalahHussain M. Aljarmouzi, Abdulsalam M. Al-MakdadMohammed H. Al-DholaeAhmed M. Al-Khawlani

Original Research

Mohammed Q. SalahDepartment of Internal Medicine, Faculty of Medicine of Health Sciences, Thamar University, Dhamar, Yemen,

Hussain M. Aljarmouzi, Department of Internal Medicine, Faculty of Medicine of Health Sciences, Thamar University, Dhamar, Yemen

Abdulsalam M. Al-MakdadDepartment of Internal Medicine, Faculty of Medicine of Health Sciences, Thamar University, Dhamar, Yemen

Mohammed H. Al-DholaeDepartment of Internal Medicine, Faculty of Medicine of Health Sciences, Thamar University, Dhamar, Yemen

Ahmed M. Al-Khawlani, Department of Internal Medicine, Al-Wahdah Teaching Hospital, Thamar University, Ma’bar City, Dhamar, Yemen


Salah MQ, Aljarmouzi HM, Al-Makdad AM, Al-Dholaee MH, Al-Khawlani AM. Prevalence & pattern of stroke among patients attending a teaching hospital in Dhamar governorate, Yemen. Annals of Medicine & Health.2019;1(1):1–4.


Background: Stroke is still one of the most life-threatening disorders in the middle and low-income countries including Yemen.

Aim: The present study was aimed to explore the prevalence and pattern of stroke among patients attending Thamar University Al-Wahdah Teaching Hospital (TUWTH), located in Ma’bar city, Dhamar governorate, Yemen.

Methods: This was a hospital-based descriptive study conducted on 1482 patients admitted to the Internal Medicine Department, including Intensive Care Unit (ICU), between January and December 2016. Suspected stroke cases were diagnosed based on their history and clinical examination, and then confirmed by computed tomography scan (CT) or magnetic resonance image (MRI) techniques. Proposed risk factors and outcome of stroke were reported for the confirmed cases.

Results: The overall prevalence of stroke was found to be 6.1% (91/1482) among the study population in Dhamar governorate. Of all stroke cases, 76.9 % were ischemic stroke and 23.1% were hemorrhagic stroke. The majority (82.4%) of the stroke patients were improved and discharged with medication. As well, hemorrhagic stroke was significantly associated with higher mortality rate compared to ischemic stroke (52.4% vs. 7.1%, P = 0.001, respectively). The mean age of stroke patients was 66.1 years. Stroke was higher among males than females (63.7% vs. 36.3%, respectively). Other proposed risk factors such as hypertension, smoking, past history of stroke, diabetes mellitus, and family history of stroke were reported in   57.1%, 47.3%, 15.8 %, 11% and 5.5% of the stroke cases, respectively. Khat chewing habit was reported in 74.73 % of the stroke patients.

Conclusion: This study gives a clear description about stroke in Dhamar governorate. However, more inferential studies should be carried out in order to give reasonable accounts regarding this significant public health problem.

Stroke, Ischemic Stroke, Hemorrhagic Stroke, Prevalence, Pattern, Dhamar, Yemen
To cite this article
  1. Mozaffarian D, Benjamin EJ, Go AS, et al. Executive summary: Heart disease and stroke statistics-2015 update : A report from the American Heart Association. Circulation. 2015;131(4):434-441.
  2. Benamer HT, Grosset D. Stroke in Arab countries: A systematic literature review. J Neurol Sci.2009;284(1-2):18-23.
  3. Leonardi-Bee J, Bath PMW, Phillips SJ, Sandercock PAG. Blood pressure and clinical outcomes in the International Stroke Trial. Stroke. 2002. doi:10.1161/01.STR.0000014509.11540.66.
  4. Whitlock RP, Sun JC, Fremes SE, Rubens FD, Teoh KH. Antithrombotic and thrombolytic therapy for valvular disease: Antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines. Chest. 2012;141(2 SUPPL.). doi:10.1378/chest.11-2305.
  5. Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics-2016 update a report from the American Heart Association. Circulation. 2016;133(4):e38-e48.
  6. Shinozaki K, Naritomi H, Shimizu T, et al. Role of insulin resistance associated with compensatory hyperinsulinemia in ischemic stroke. Stroke. 1996;27(1):37-43.
  7. Maruthur NM, Wang N-Y, Appel LJ. Lifestyle Interventions Reduce Coronary Heart Disease Risk: Results From the PREMIER Trial. Circulation. 2009;119(15):2026-2031.
  8. Bhat VM, Cole JW, Sorkin JD, et al. Dose-response relationship between cigarette smoking and risk of ischemic stroke in young women. Stroke. 2008;39(9):2439-2443.
  9. Hillbom M, Numminen H, Juvela S. Recent heavy drinking of alcohol and embolic stroke. Stroke. 1999;30(11):2307-2312. 19.
  10. Kurth T. Body Mass Index and the Risk of Stroke in Men. Arch Intern Med. 2002;162(22):2557-2562.
  11. Abbott RD, Rodriguez BL, Burchfiel CM, Curb JD. Physical activity in older middle-aged men and reduced risk of stroke: The honolulu heart program. Am J Epidemiol. 1994;139(9):881-893.
  12. Brown RD, Whisnant JP, Sicks JD, O’Fallon WM, Wiebers DO. Stroke incidence, prevalence, and survival: secular trends in Rochester, Minnesota, through 1989. Stroke. 1996;27(3):373-380.
  13. Palm F, Urbanek C, Wolf J, et al. Etiology, risk factors and sex differences in ischemic stroke in the ludwigshafen stroke study, a population-based stroke registry. Cerebrovasc Dis. 2012;33(1):69-75.
  14. Welin L, Svärdsudd K, Wilhelmsen L, Larsson B, Tibblin G. Analysis of Risk Factors for Stroke in a Cohort of Men Born in 1913. N Engl J Med. 1987;317(9):521-526.
  15. Feng W, Hendry RM, Adams RJ. Risk of recurrent stroke, myocardial infarction, or death in hospitalized stroke patients. Neurology. 2010;74(7):588-593.
  16. Howard G, Anderson R, Sorlie P, Andrews V, Backlund E, Burke GL. Ethnic differences in stroke mortality between non-hispanic whites, hispanic whites, and blacks the national longitudinal mortality study. Stroke. 1994;25(11):2120-2125.
  17. He J, Klag MJ, Wu Z, Whelton PK. Stroke in the People’s Republic of China : I. Geographic Variations in Incidence and Risk Factors. Stroke. 1995;26(12):2222-2227.
  18. Hassan NAGM, Gunaid AA, Murray-Lyon IM. khat (Catha edulis): Health aspects of khat chewing. East Mediterr Heal J. 2007;13(3):706-718.
  19. Ali WM, Zubaid M, Al-Motarreb A, et al. Association of khat chewing with increased risk of stroke and death in patients presenting with acute coronary syndrome. Mayo Clin Proc. 2010;85(11):974-980.
  20. James PA, Oparil S, Carter BL, et al. 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults.Report from the panel memebers appointed to the Eight Joint National Committe (JNC 8). JAMA. 2013. doi:10.1001/jama.2013.284427.
  21. American Diabetes Association. National Diabetes Statistics Report , 2014 Estimates of Diabetes and Its Burden in the Epidemiologic estimation methods. Natl Diabetes Stat Rep. 2014.
  22. Al-Rubeaan, K. et al. Ischemic Stroke and Its Risk Factors in a Registry-Based Large Cross-Sectional Diabetic Cohort in a Country Facing a Diabetes Epidemic. J Diabetes Res 2016, 4132589 (2016).
  23. Hong KS , Bang OY , Kang DW , et al. Stroke statistics in Korea: part I. Epidemiology and risk factors: a report from the Korean stroke society and clinical research center for stroke. J Stroke 2013;15:2.doi:10.5853/jos.2013.15.1.2.
  24. Hanchaiphiboolkul S , Poungvarin N , Nidhinandana S , et al. Prevalence of stroke and stroke risk factors in Thailand: Thai Epidemiologic Stroke (TES) Study. J Med Assoc Thai 2011;94:427.
  25. Centers for Disease Control and Prevention (CDC). Prevalence of stroke--United States, 2006-2010. 61: Morbidity and mortality weekly report, 2012:379.
  26. Teh WL, Abdin E, Vaingankar JA, et al. Prevalence of stroke, risk factors, disability and care needs in older adults in Singapore: results from the WiSE study. BMJ Open 2018;8:e020285. doi: 10.1136/bmjopen-2017-020285.
  27. Sallam AR, Al-Aghbari K, Awn H. The clinical profile of stroke: A Yemeni experience. Jordan Med J. 2009;43(2):115-121.
  28. Hassan HM, Idriss HM, Sarah MES. Risk factors, electrolyte disturbances and lipid profiles in sudanese patients with stroke. J Public Heal Epidemiol. 2015;9(10):324-330.
  29. Rajeh S Al, Awada A, Niazi G, Larbi E. Stroke in a Saudi Arabian National Guard Community: Analysis of 500 consecutive cases from a population-based hospital. Stroke. 1993;24(11):1635-1639.
  30. Al-Rajeh S, Larbi EB, Bademosi O, et al. Stroke register: Experience from the Eastern Province of Saudi Arabia. Cerebrovasc Dis. 1998;8(2):86-89.
  31. Deresse B, Shaweno D. Epidemiology and in-hospital outcome of stroke in South Ethiopia. J Neurol Sci. 2015;355(1-2):138-142.
  32. Al-Jishi AA, Mohan PK. Profile of stroke in Bahrain. Saudi Med J. 1999;20(12):958-962.
  33. Bahou Y, Hamid H, Raqab MZ. Ischemic stroke in Jordan 2000 to 2002: A two-year, hospital-based study. J Stroke Cerebrovasc Dis. 2004;13(2):81-84.
  34. Delbari A, Salman Roghani R, Tabatabaei SS, Rahgozar M, Lokk J. Stroke epidemiology and one-month fatality among an urban population in Iran. Int J Stroke. 2011;6(3):195-200.
  35. Khan NI, Naz L, Mushtaq S, Rukh L, Ali S, Hussain Z. Ischemic stroke: Prevalence of modifiable risk factors in male and female patients in Pakistan. Pak J Pharm Sci. 2009;22(1):62-67.
  36. R.M. B, H.S. AG, N.S. M. Age, sex and stroke type differences in stroke patients at Mukalla, Hadhramout, Republic of Yemen: Analysis of 1072 cases. J Neurol Sci. 2013;333(2013):e263. doi:10.1016/j.jns.2013.07.1008.
  37. McLachlan RS. Cerebrovascular disease in United Arab Emirates nationals. Emirates Med J. 2002;20(2):153-156.
  38. Al-Asadi J, Habib H. Risk factors and 30-day case fatality of first-ever stroke in Basrah, Iraq. Niger Med J. 2014;55(3):209.
  39. Ashok PP, Radhakrishnan K, Sridharan R, El-Mangoush MA. Incidence and pattern of cerebrovascular diseases in Benghazi, Libya. J Neurol Neurosurg Psychiatry. 1986;49(5):519-523.



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