Oxford-Cameroon Atherosclerosis and Stroke Study (OxCASS)

It is uncertain whether stroke prevention strategies are applicable across continents and ethnic groups, particularly in Populations of African Descent (PAD). Studies in high-income countries have reported ethnic differences in epidemiology and pathobiology of cervical and intracranial atherosclerotic disease (CIAD) but have only included small numbers of Black Africans. There are few studies in Africa where environmental and genetic factors differ. I aim to determine the epidemiology and pathobiology of CIAD in PAD living in the UK and in Africa. In phase-1 (years 1-2), working with cohorts and datasets in UK, I will describe differences in burden, risk factors, mechanism, and prognosis of stroke and CIAD in PAD versus other ethnic groups. In phase-2 (years 3-5), I will conduct a prospective case-control study in Cameroon enrolling 500 acute stroke cases and 500 population controls to clarify the contribution of CIAD to stroke risk in Africans and investigate how sociocultural and environmental factors affect the outcome of stroke and CIAD. My project will generate high-quality epidemiological data that are indispensable to inform adjustment of prevention policies for PAD living in UK and Africa, and establish a biobank (plasma, DNA) to enable discovery research on stroke and CIAD in Africa (Phase-3).