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Quality of life of stroke survivors in Africa: a systematic review and meta-analysis

Quality of Life Research volume 30, pages 1–19 (2021)Cite this article

Abstract

Purpose

Functional impairments and socioeconomic constraints associated with stroke affect quality of life (QoL). With limited care and social support resources, there is a greater anticipated decline in QoL among stroke survivors in Africa. This study aims to examine post-stroke QoL, properties of outcome measures adopted and predictors of the QoL among African stroke survivors.

Methods

African Journals Online, CINAHL, PsychINFO, PubMed and Web of Science databases were searched from inception to February 2020. Methodological quality was assessed using the Agency for Healthcare Research and Quality (ARHQ) methodology checklist for observational studies.

Results

Twenty-eight studies recruiting 2572 (76.4%) stroke survivors and 795 (23.6%) healthy volunteers were included. Studies were conducted in eight African countries between 2007 and 2019. Methodological quality of studies was good. Overall, stroke survivors reported a low QoL. Six studies comparing QoL between stroke survivors and healthy controls were pooled for meta-analysis. Results showed a biased-adjusted standardised mean difference (Hedges’s g) of 1.13 (95% CI 0.71 to 1.56; p < 0.001), indicating better QoL among healthy controls. Only 4 (14.3%) studies used translated or cross-culturally adapted QoL assessment tools. The most commonly reported predictor of QoL was post-stroke disability (35.8% of studies) which is followed by depression (28.6%) and stroke severity (28.6%).

Conclusions

Overall, African stroke survivors reported comparatively lower QoL as compared to age-matched healthy controls. This highlights the need for cross-culturally validated assessment tools and more robust post-stroke QoL evaluation across the African continent. To improve QoL of stroke survivors in Africa, early interventions should focus on reducing disability and depression associated with stroke.

PROSPERO registration number: CRD42019137653.

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Acknowledgement

There is no source of funding for this study and authors declared no financial conflict of interest.

Funding

None.

Author information

Affiliations

  1. Yobe State University Teaching Hospital, Damaturu, Yobe State, Nigeria

    Umar Muhammad Bello

  2. Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China

    Umar Muhammad Bello, Tiev Miller & Stanley John Winser

  3. Faculty of Human Sciences, Macquarie University, Sydney, Australia

    Muhammad Chutiyami

  4. Shehu Sule College of Nursing and Midwifery Damaturu, Damaturu, Yobe State, Nigeria

    Muhammad Chutiyami

  5. School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China

    Dauda Salihu

  6. Physiotherapy Department, Kazaure General Hospital, Kazaure, Jigawa State, Nigeria

    Sham’un Isah Abdu

  7. Physiotherapy Department, Bauchi State Specialist Hospital, Bauchi, Bauchi State, Nigeria

    Buhari Abdullahi Tafida & Adamu Gamawa

  8. Department of Physiotherapy, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria

    Abdulhamid Ardo Jabbo

  9. Physiotherapy Department, Federal Medical Centre, Azare, Bauchi State, Nigeria

    Lawan Umar

  10. Department of Rehabilitation Sciences, University of Maiduguri, Maiduguri, Borno State, Nigeria

    Aliyu Lawan

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  1. Umar Muhammad Bello
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  2. Muhammad Chutiyami
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  4. Sham’un Isah Abdu
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  10. Tiev Miller
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  11. Stanley John Winser
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Correspondence to Muhammad Chutiyami.

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Bello, U.M., Chutiyami, M., Salihu, D. et al. Quality of life of stroke survivors in Africa: a systematic review and meta-analysis. Qual Life Res 30, 1–19 (2021). https://doi.org/10.1007/s11136-020-02591-6

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Keywords

  • Stroke survivors
  • Quality of life
  • Predictors
  • Africa
  • Cross-cultural