Prevalence of HIV infection among stroke patients in Douala.

To determine the prevalence of HIV infection among stroke patients admitted to the Douala General Hospital (DGH) and to describe the clinical characteristics and outcome of the stroke patients with HIV infection. This prospective cohort study took place in 2010-2015 at the DGH. The study included patients older than 15 years with a CT-confirmed stroke. All patients underwent HIV tests with Western-Blot confirmation. The functional prognosis of the patients was assessed by the Rankin score at 6 months after stroke onset. The prevalence rate of HIV among stroke patients was 6.6% (40/608). Of the 40 HIV-positive patients, 58% were aware of their status at admission; 83% of these patients were receiving antiretroviral therapy. Males were predominant (65%), and the mean age was 51.3 ± 10.4 years. Hypertension was the main cerebrovascular risk factor (65%). At admission, 47.5% of HIV+ patients were febrile, and 7.5% presented with coma. Ischemic stroke accounted for 60% of cases. The mean CD4 cell count was 351 ± 236/mm3 with a median of 330/mm3. The length of stay was 10 ± 8 days. At 6 months, the cumulative mortality of HIV+ patients was 37.5%, and 38.5% were dependent (Rankin>2). HIV prevalence is high among stroke patients in our setting. This suggests that an HIV test should be routinely proposed to stroke patients.

Predictors of in-hospital mortality for stroke in douala, cameroon.

Background. The objective of this study was to describe complications in hospitalized patients for stroke and to determine the predictive factors of intrahospital mortality from stroke at the Douala General Hospital (DGH) in Cameroon. Patients and Methods. A prospective cross-sectional study was carried out from January 1, 2010 to December 31, 2012, at the DGH. All the patients who were aged more than 15 years with established diagnosis of stroke were included. A univariate analysis was done to look for factors associated with the risk of death, whilst the predictive factors of death were determined in a multivariate analysis following Cox regression model. Results. Of the 325 patients included patients, 68.1% were males and the mean age was 58.66 ± 13.6 years. Ischaemic stroke accounted for 52% of the cases. Sepsis was the leading complications present in 99 (30.12%) cases. Independent predicting factors of in-hospital mortality were Glasgow Coma Scale lower than 8 (HR = 2.17 95% CI 4.86-36.8; P = 0.0001), hyperglycaemia at admission (HR = 3.61 95% CI 1.38-9.44; P = 0.009), and hemorrhagic stroke (HR = 5.65 95% CI 1.77-18; P = 0.003). Conclusion. The clinician should systematically diagnose and treat infectious states and hyperglycaemia in stroke.