ABSTRACT NUMBER: ESOC2026LB28 STROKE IN YOUNG ADULTS IN SUB-SAHARAN AFRICA: A SYSTEMATIC REVIEW OF EVIDENCE

Abstract Background and aims Stroke among young adults is a growing problem in Sub-Saharan Africa (SSA). However, data on its epidemiology, risk factors, stroke subtypes, and outcomes remain fragmented. The goal of this systematic review was to critically appraise and synthesize evidence on the characteristics of stroke in young adults in SSA. Methods We searched PubMed, African Journals Online, Google Scholar, Cochrane Library, and Sabinet Journals from January to May 2025 for studies on stroke in young adults in SSA. This review was done following the PRISMA guidelines. We used the Critical Appraisal Skills Program checklist to determine the quality of the included studies. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to estimate the certainty of the evidence. Results Twenty studies were included in this review. Young stroke accounted for approximately 8–33% of all stroke cases, with 35–49 years being the most affected age group. Ischemic stroke was the most common subtype overall. Hypertension was the most consistently reported risk factor, followed by diabetes mellitus, alcohol use, smoking, dyslipidemia, HIV infection, sickle cell disease, and oral contraceptive use. Large artery atherosclerosis and cardioembolism were the most frequent etiologies of ischemic stroke, while hypertension predominated in hemorrhagic stroke. Case fatality rates ranged from <10% to over 50%. Survivors frequently experienced significant functional impairment and reduced quality of life. Conclusions Stroke in young adults in SSA is a largely preventable public health problem driven by modifiable risk factors. Strengthening primary prevention and improving acute stroke care could substantially reduce this burden. Conflict of interest