BACKGROUND Acute infections have been posited as potential precipitants or triggers of the occurrence of stroke among adults with traditional vascular risk factors. We evaluated associations between stroke occurrence and reported febrile illness within 4 weeks (potential antecedent infections) among West Africans. METHODS The Stroke Investigative Research and Educational Network (SIREN) is a multicenter, case-control study involving 15 sites in Ghana and Nigeria. Cases include adults aged ≥18 years with radiologically confirmed strokes. Controls were stroke-free adults matched with cased by age, gender and ethnicity. Detailed evaluations for vascular, lifestyle and psychosocial factors were performed. Participants were asked for evidence of any febrile illness within the past 4 weeks. We used conditional logistic regression to estimate adjusted odds ratios (aOR) with 95% Confidence Interval. RESULTS Among 3588 stroke cases recruited in Ghana and Nigeria between August 2014 and July 2018, 363 cases (10.1%) reported having a febrile illness within the 4 weeks prior to stroke occurrence. Having an antecedent infection was associated with stroke occurrence with an unadjusted OR of 1.19 (1.00-1.51) but aOR of 0.83 (0.59-1.17) upon adjusting for traditional vascular risk factors. Stress, aOR of 4.69 (2.59-8.50) and consumption of green vegetables 2.27 (1.35-2.85) were associated with antecedent febrile illness. CONCLUSION 1 in 10 stroke cases reported antecedent history of febrile illness prior to occurrence of stroke but no independent association was observed in this study. Infectious exposures may be important triggers of cardiovascular events requiring further exploratory studies to better understand the role of this emerging risk factor.

中文翻译：

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西非的发热性疾病发生史和中风发生率：SIREN 研究


背景急性感染被认为是具有传统血管危险因素的成年人中风发生的潜在诱因或触发因素。我们评估了西非人中风发生率与 4 周内报告的发热性疾病（潜在的既往感染）之间的关联。方法 中风调查研究和教育网络 (SIREN) 是一项多中心病例对照研究，涉及加纳和尼日利亚的 15 个地点。病例包括年龄≥18岁且经放射学证实中风的成年人。对照组是无中风的成年人，其病例按年龄、性别和种族进行匹配。对血管、生活方式和社会心理因素进行了详细评估。参与者被要求提供过去 4 周内任何发热性疾病的证据。我们使用条件逻辑回归来估计置信区间为 95% 的调整优势比 (aOR)。结果 2014年8月至2018年7月期间在加纳和尼日利亚招募的3588例中风病例中，363例（10.1%）报告在中风发生前4周内患有发热性疾病。既往感染与卒中发生相关，未经调整的 OR 为 1.19 (1.00-1.51)，但调整传统血管危险因素后，aOR 为 0.83 (0.59-1.17)。压力、aOR 4.69 (2.59-8.50) 和食用绿色蔬菜 2.27 (1.35-2.85) 与既往发热性疾病相关。结论 每 10 名中风病例中就有 1 人在中风发生前报告有发热性疾病史，但本研究中未观察到独立关联。感染性暴露可能是心血管事件的重要触发因素，需要进一步的探索性研究，以更好地了解这一新兴危险因素的作用。