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Popoola O, Ovbiagele B, Arulogun O, Akinyemi J, Akinyemi R, Uvere E, Akpa O, Salami A, Taiwo O, Olaniyan L, Walker R, Jenkins C, Owolabi M. African Rigorous Innovative Stroke Epidemiological Surveillance: Protocol for a Community-Based Mobile-Health Study. Neuroepidemiology 2022; 56:17-24. [PMID: 34903691 PMCID: PMC9840813 DOI: 10.1159/000518885] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/30/2021] [Indexed: 01/18/2023] Open
Abstract
Despite projections of stroke being a leading cause of mortality in Africa, reliable estimates of stroke burden on the continent using rigorous methods are not available. We aimed to implement a mobile-Health community-based interactive Stroke Information and Surveillance System to sustainably measure stroke burden and improve stroke health literacy and outcomes in urban and rural sites in Nigeria. African Rigorous Innovative Stroke Epidemiological Surveillance (ARISES) is an observational cohort study, which will be conducted in urban (Ibadan North LGA Ward 3) and rural (Ibarapa Central LGA) sites with a combined base population of over 80,000 people. The study will use a consultative approach to establish an mHealth-based Stroke Information and Surveillance System comprising a Stroke Alert System and a Stroke Finding System. These systems will enable the community to report stroke events and the research team/health workers find stroke cases using phone calls, short message service, and Voice Over Internet Protocols (VoIP). We will update community household data and geo-locate all households. Over the 5 years of the study, the system will collect information on stroke events and educate the community about this disease. Reported stroke cases will be clinically adjudicated at home and in prespecified health facilities. Baseline and endline community surveys will be conducted to assess stroke occurrence and other important study variables. The proportion of strokes alerted and found will be determined over the study period. Focus group discussions and key informant interviews will be conducted to understand community stroke literacy and perspectives. The study will also assess any impact of these efforts on time from stroke onset to referral, community uptake of orthodox health services for stroke patients. ARISES is anticipated to establish proof of concept about using mHealth for stroke surveillance in Africa. The potential impact of the SISS on improving patient outcomes will also be determined.
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Affiliation(s)
- Oluwafemi Popoola
- Department of Community Medicine, College of Medicine, University of Ibadan, Nigeria
| | - Bruce Ovbiagele
- Weill Institute for Neurosciences, University of California San-Francisco, USA
| | - Oyedunni Arulogun
- Department of Health Promotion, College of Medicine, University of Ibadan, Nigeria
| | - Joshua Akinyemi
- Department of Epidemiology and Statistics, College of Medicine, University of Ibadan
| | - Rufus Akinyemi
- Neuroscience and Ageing Research Unit, IAMRAT, College of Medicine, University of Ibadan, Nigeria,Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Nigeria
| | - Ezinne Uvere
- Department of Medicine, Newcastle University, United Kingdom
| | - Onoja Akpa
- Department of Epidemiology and Statistics, College of Medicine, University of Ibadan
| | - Ayodeji Salami
- Department of Pathology, College of Medicine, University of Ibadan, Nigeria
| | - Olalekan Taiwo
- Department of Geography, Faculty of the Social Sciences, University of Ibadan, Nigeria
| | - Lanre Olaniyan
- Department of Economics, Faculty of Social Sciences, University of Ibadan, Nigeria
| | - Richard Walker
- College of Nursing, Medical University of South Carolina, Charleston, USA
| | - Carolyn Jenkins
- Department of Medicine, Newcastle University, United Kingdom
| | - Mayowa Owolabi
- Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Nigeria,Department of Medicine, College of Medicine, University of Ibadan, Nigeria
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Zeng S, Luo L, Chen F, Li Y, Chen M, He X. Association of outdoor air pollution with the medical expense of ischemic stroke: The case study of an industrial city in western China. Int J Health Plann Manage 2021; 36:715-728. [PMID: 33474742 DOI: 10.1002/hpm.3115] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 11/05/2020] [Accepted: 12/28/2020] [Indexed: 11/11/2022] Open
Abstract
Ischemic stroke, the most frequent cause of severe disability, imposes a significant mental and economic burden on patients and their families. There is increasing evidence to indicate that air pollution contributes to the risk of ischemic stroke. This study aimed to examine the correlation between air pollution and the expense imposed by an ischemic stroke. Data were obtained from hospitals and environmental monitoring stations in an industry city, Longspring, in western China. We used a generalized additive model to estimate the associations between the two factors, measured during 2015-2017. Counter-intuitively, the medical expenses arising from ischemia were negatively associated with the level of air pollution. The corresponding ER for per interquartile range increase of PM2.5, PM10, SO2 , and NO2 in lag10 was -0.17% (95% confidence interval (95% CI -0.31%, -0.03%), -0.11% (95% CI -0.2%, -0.02%), -1.04% (95% CI -1.92%, -0.17%) and -0.44% (95% CI -0.66%, -0.22%), respectively (p < 0.05). Subgroups based on gender, age, and season were considered in the analysis. The results indicated that pollutants had significant effects on ischaemia's medical expenses, which were stronger for older people, patients who survived, and warm seasons. This study is the first step in optimizing medical resources, which are essential for policymaking and service planning.
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Affiliation(s)
- Siyu Zeng
- Business School, Sichuan University, Chengdu, China
| | - Li Luo
- Business School, Sichuan University, Chengdu, China
| | - Fang Chen
- Department of Neurosurgery, First People's Hospital of Longquan, Chengdu, China
| | - Yue Li
- Business School, Sichuan University, Chengdu, China
| | - Mei Chen
- Department of Record Room, First People's Hospital of Longquan, Chengdu, China
| | - Xiaozhou He
- Business School, Sichuan University, Chengdu, China
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