Determinants of health outcomes of stroke survivors in Africa: A systematic review and meta-analysis.

The overall pooled estimates of clinical risk factors among stroke survivors indicated a statistically significant association with health outcomes.

• Pooled odds ratio of 1.446 (95% CI: 1.202-1.739, P < 0.001) based on 11 studies
• A random-effects meta-analysis model was used to synthesise findings
• The analysis was derived from studies conducted across seven African countries

Stroke severity and neurological status was the most frequently reported clinical determinant of health outcomes among stroke survivors in Africa.

• Stroke severity/neurological status was reported in 19 of 40 studies assessing clinical determinants
• Clinical determinants were reported across 40 of the 52 included studies
• Studies were published between October 1987 and April 2025 across seven African countries

Biomarkers and blood parameters were the second most commonly reported clinical determinant of stroke outcomes.

• Biomarkers and blood parameters were reported in 18 of 40 studies assessing clinical determinants
• This was the second most frequently reported clinical factor after stroke severity/neurological status

Abnormal radiological and imaging findings were identified as a key clinical determinant of health outcomes in stroke survivors.

• Abnormal radiological/imaging findings were reported in 10 of 40 studies assessing clinical determinants
• This was the third most commonly reported clinical determinant

Psychosocial determinants, particularly mental health, emotional well-being, and social support, were identified as key factors influencing stroke outcomes.

• 12 of the 52 included studies assessed psychosocial factors
• Mental health and emotional well-being, especially from social support, was reported in 6 psychosocial studies
• Quality-of-life domains were reported in 5 psychosocial studies

The majority of included studies were assessed as having low risk of bias using the Newcastle-Ottawa Scale.

• 47 of the 52 included studies were classified as low risk of bias
• The remaining 5 studies were classified as moderate risk of bias
• Methodological quality was assessed using the Newcastle-Ottawa Scale

The systematic review identified 52 studies from seven African countries that met inclusion criteria from a total of 979 articles identified.

• 979 articles were identified from literature searches conducted in EBSCOhost, Scopus, and Web of Science databases
• Studies were published from inception to April 14, 2025, with the earliest included study from October 1987
• The review adhered to PRISMA guidelines and was registered on PROSPERO (CRD42025629244)
• Only original research on stroke survivors in Africa was included