Factors associated with stroke direct cost in francophone West Africa, Benin example


Background: In sub-Saharan Africa, stroke constitutes a public health issue. Few studies were conducted to assess the cost involved in its treatment. Objective: To determine the factors involved in direct cost of stroke in Cotonou-Benin. Method: It consists in a transversal and prospective research of economic type with analytical and descriptive aim. It was conducted from 20thFebruary 2011 to 30thSeptember 2011. The research dealt with 122 stroke patients. With regard to the economic approach, bottom-up was the data collection technique which was adopted. Cost was estimated not only based on the patient himself/herself but considering societal aspect. Cost estimation period was hospitalization period. Data analysis was conducted via software such as Epi info and SPSS. Results: Overall expenses in terms of direct cost varied from $144.9 to $9393.9; average expenses were $1030.1 ± $101.7. Patients aged 50 and above had higher stroke hospitalization cost ($1277.4) than those aged below 50 ($857.4) p = 0.001; male patients made more expenses than females (FCFA 1157.5 against $831.8) p = 0.01; direct cost of stroke was increased in proportion to neurological deficit (score NIHSS) p = 0.043. This cost was higher in cases of hemorrhagic stroke than ischemic stroke (FCFA $1375 against $1098) p = 0.002. Stroke direct cost was also increased in proportion to severance of disability level of patients. Stroke type (hemorrhagic) and RANKIN score were firmly correlated to stroke hospitalization cost. Conclusion: Stroke is very expensive for patientsin Benin and they constitute a burden for both patients and their family. There is a great need to increase awareness regarding risk factor control in order to reduce the cost involved in treating this malady.

Share and Cite:

Gnonlonfoun, D. , Adoukonou, T. , Adjien, C. , Nkouei, E. , Houinato, D. , Avode, D. and Preux, P. (2013) Factors associated with stroke direct cost in francophone West Africa, Benin example. World Journal of Neuroscience, 3, 287-292. doi: 10.4236/wjns.2013.34039.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Sène Diouf, F., Basse, A.M., Ndao, A.K. and Ndiaye, M. (2006) Stroke functional prognostic in developing countries: Sénégal. Annales de Réadaptation et de Médecine Physique, 89, 100-104.
[2] Smadja, D., Olindo, S. and Cabre, P. (2002) Stroke among Blacks in tropical zones. Neurology, 5, 211-215.
[3] Patel, A., Knapp, M., Evans, A., Perez, I. and Kalra, L. (2004) Training care givers of stroke patients: Economic evaluation. BMJ, 328, 1102-1108.
[4] Mamoli, A., Censori, B., Casto, L., Sileo, C., Cesana, B. and Camerlingo, M. (1999) An analysis of the costs of ischemic stroke in an Italian stroke unit. Neurology, 53, 112-116. http://dx.doi.org/10.1212/WNL.53.1.112
[5] Claesson, L., Gosman-Hedstrom, G., Johannesson, M., Fagerberg, B. and Blomstrand, C. (2000) Resource utilization and costs of stroke unit care integrated in a care continuum: A 1-year controlled, prospective, randomized study in elderly patients: The Goteborg 70+ Stroke Study. Stroke, 31, 2569-2577.
[6] Demaerschalk, B. and Durocher, D.L. (2007) How diagnosis-related group 559 will change the US Medicare cost reimbursement ratio for stroke centers. Stroke, 38, 1309-1312.
[7] Keita, A.D., Touré, M. and Diawara, A. (2005) Stroke epidemiological aspects in ct scan department at point G hospital in Bamako, Mali. Tropical Medicine, 65, 453-457.
[8] Jorgensen, H.S., Nakayama, H., Raaschou, H.O. and Olsen, T.S. (1997) Acute stroke care and rehabilitation: An analysis of the direct cost and its clinical and social determinants. The Copenhagen stroke study. Stroke, 28, 1138-1141. http://dx.doi.org/10.1161/01.STR.28.6.1138
[9] Brown, D.L., Boden-Albala, B., Langa, K.M., Lisabeth, L.D., Fair, M., Smith, M.A., et al. (2006) Projected costs of ischemic stroke in the United States. Neurology, 67, 1390-1395.
[10] Chiu, L., Shyu, W.C. and Chen, T.R. (1997) A cost-effectiveness analysis of home care and community based nursing homes for stroke patients and their families. Journal of Advanced Nursing, 26, 872-878.
[11] Beech, R., Rudd, A.G., Tilling, K. and Wolfe, C.D. (1999) Economic consequences of early inpatient discharge to community-based rehabilitation for stroke in an innerLondon teaching hospital. Stroke, 30, 729-735.
[12] Launois, R., Giroud, M., Mégnigbêto, A.C., Le Lay, K., Présenté, G., Mahagne, M.H., et al. (2004) Estimating the cost-effectiveness of stroke units in France compared with conventional care. Stroke, 35, 770-775.
[13] Touré, K., Ndiaye, N.M., Sène Diouf, F., Ndiaye, M., Diallo, A.K., Ndao, A.K., et al. (2005) Assessing the cost of stroke in Dakar-Sénégal. Tropical Medicine, 65, 458-464.
[14] Smurawska, L.T, Alexandrov, A.V., Bladin, C.F. and Norris, J.W. (1994) Cost of acute stroke care in Toronto, Canada. Stroke, 25, 1628-1631.
[15] Gladman, J., Whynes, D. and Lincoln, N. (1994) Cost comparison of domiciliary and hospital based stroke rehabilitation. DOMINO Study Group. Age Ageing Stroke, 23, 241-245. http://dx.doi.org/10.1093/ageing/23.3.241
[16] Patel, A., Knapp, M., Perez, I., Evans, A. and Kalra, L. (2004) Alternative strategies for stroke care: Cost-effectiveness and cost-utility analyses from a prospective randomized controlled trial. Stroke, 35, 196-203.
[17] Saka, O., McGuire, A. and Wolfe, C. (2009) Cost of stroke in the United Kingdom. Age and Ageing, 38, 27-32.
[18] Fagerberg, B., Claesson, L., Gosman-Hedstrom, G. and Blomstrand, C. (2000) Effect of acute stroke unit care integrated with care continuum versus conventional treatment: A randomized 1-year study of elderly patients: The Goteborg 70+ Stroke Study. Stroke, 31, 2578-2584.
[19] Teasell, R.W., Foley, N.C., Bhogal, S.K. and Speechley, M.R. (2003) Early supported discharge in stroke rehabilitation. Topics in Stroke Rehabilitation, 10, 19-33.
[20] Dewey, H., Thrift, A., Mihalopoulos, C., Carter, R., Macdonell, R. and McNeil, J. (2003) Lifetime cost of stroke subtypes in Australia: Findings from the North East Melbourne stroke incidence study (NEMESIS). Stroke, 34, 2502-2507.
[21] Evers, S., Strijs, J., Ament, A., van Genugten, M., Jager, J. and van den Bos, G. (2004) International comparison of stroke cost studies. Stroke, 35, 1209-1215.

Copyright © 2022 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.