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Stroke in Sierra Leone

Stroke in Sierra Leone (SISLE) is a research group aiming to improve outcomes for stroke patients in Sierra Leone. Led by Professor Catherine Sackley, we are a collaboration between King’s and the College of Medicine and Allied Health Sciences.

We are funded by the Global Health Research strand of the National Institute for Health Research (NIHR).

Stroke is becoming more common in many low- and middle-income countries, where as many as 86% of all stroke related deaths occur.

We have seen that changes to health systems, improvements in clinical stroke care and the management of risk factors have reduced both the incidence of and mortality from strokes in high-income countries.

Little is known about stroke in Sierra Leone, however. SISLE will, therefore, establish a stroke register based at Connaught Hospital (Sierra Leone’s adult tertiary referral hospital); a key step in defining risk, improving patient outcomes and driving health system improvements.

What is the purpose of the study?

We set up SISLE to find out how many people in Sierra Leone have a stroke and how stroke affects them and their families. This information is useful to help improve the quality of care people receive while they are in hospital and in the years to come. We use it to: increase our knowledge about stroke; help improve quality of care at the hospital; publish scientific articles about stroke.

Who runs the SISLE Stroke Register?

The Register is run by an international stroke research team, including researchers from College Of Medicine and Allied Health Sciences and King’s College London.  We are based in the research office at Connaught Hospital.

The research team includes doctors, nurses and physiotherapists.

A member of the team, will have contact with you regarding the study but will not be involved with your routine clinical care.

Why are you asking me to take part?

We ask everyone who may have had a stroke, who comes to Connaught Hospital to take part. We are in contact with all hospital wards and departments where stroke patients might be seen.   If it later turns out that you have not had a stroke, we would like to keep a record of what your actual diagnosis was so that we understand what other conditions are causing stroke-like symptoms, but you will not need to continue with the other parts of the study.

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Who can take part?

Anyone presenting with suspected stroke at USLTHC-Connaught Hospital with suspected stroke as per the WHO's definition:

“Rapidly developing clinical signs of focal (or global) neurological deficit lasting more than 24 hours or leading to death, with no apparent cause other than that of vascular origin”.

  • Adults 16 years or over
  • Ischaemic stroke
  • Intracerebral haemorrhage
  • Sub Arachnoid Haemorrhage

The following people will not be able to take part:

  • Under 16 years
  • No consent
  • Transient Ischaemic Attack (focal neurological signs recovering within 24 hours)
  • Known neurological disease with infectious etiology; meningitis, brain abcess, encephalitis

What will happen if I take part?

We will ask you to sign a consent form to show that you have agreed to take part in this study.

A researcher from our team will ask you for information at the time of your stroke, then 3 months and 12 months after that. Then we will contact you again once every year as we would like to follow your progress for many years to come.

The first time we see you we will ask you about:

  • Your age, sex and ethnicity
  • Your health including blood pressure, cholesterol, diabetes and medication
  • Care you received in hospital and care you received before coming to hospital
  • Your ability to do certain tasks, like getting washed and dressed. 

The researcher will also do a brief physical examination (similar to that of the doctors) to find out more about how the stroke has affected you. This should not be painful or uncomfortable and you can ask to stop at any time. You are welcome to have a friend or relative present for support.

The research team will support you to access investigations that should be part of your normal recommended hospital care, and cover their cost, including:

  • CT- brain scan
  • Chest X ray
  • ECG
  • Blood tests

The research team will help you access these investigations, whether you choose to participate in the research or not.

The research team can explain each of these investigations to you in greater depth.

In later visits we will ask you about:

  • Your health and well-being, and your medications.
  • How the stroke affects you now.
  • Any medical and social care you received.

Each interview lasts between 40 – 60 minutes. The researcher will arrange to come to you, or meet you at the hospital at a time that suits you. You may be approached by the team for further information until 31/03/2021.

What are the possible benefits of taking part?

We cannot promise the stroke register will help you personally, but the information we get will help to improve care for people who have a stroke in the future. 

What if I change my mind?

Even if you agree to take part today, you can withdraw at any time without giving a reason. The final date you can withdraw by is 31/12/2021.

Our partners

The project is funded by the Global Health Research strand of the National Institute for Health Research (NIHR).

National Institute for Health Research