Epidemiological and clinical profile of ischemic, hemorrhagic, and mixed strokes in Sikasso, Mali: a prospective cross-sectional study.

INTRODUCTION

in sub-Saharan Africa, stroke places a substantial burden on health systems and populations. Clinical and epidemiological features vary by subtype, ischemic, hemorrhagic, and mixed, but data specific to Mali are limited. This study characterises, in Sikasso, the profiles linked to each stroke type.

METHODS

from November 2021 to October 2022, a prospective cross-sectional study included 135 CT-confirmed stroke admissions. Socio-demographic, clinical, and biological information was collected at presentation. We used descriptive and bivariate statistics and performed multiple correspondence analysis (MCA) to delineate profiles for ischemic, hemorrhagic, and mixed strokes.

RESULTS

patients had a mean age of 60.4 ± 12.6 years; subtype distribution was ischemic 74.8%, hemorrhagic 21.5%, mixed 3.7%. Severe hypertension was predominant in the hemorrhagic group, whereas hyperglycemia was more common in patients with ischemic or mixed strokes. The MCA identified distinct profiles. Hemorrhagic stroke: cardiovascular profile marked by grade 2-3 hypertension and left ventricular hypertrophy. Mixed stroke: metabolic and cardiac profiles associated with ischemic cardiomyopathy and living in the suburbs. Ischemic stroke: heterogeneous profile with no dominant modality.

CONCLUSION

this study highlights the different clinical profiles depending on the stroke type, reinforcing the importance of tailored care and targeted prevention strategies in Sikasso. The results underscore the central role of severe hypertension in hemorrhagic strokes and hyperglycemia in ischemic and mixed strokes.