Although stroke is a discrete phenotype, it is the clinical culmination of several complex and interacting biological processes, precipitated by various genetic and environmental factors, thereby making ready analyses of its underlying mechanisms a challenge. However, the formulation of successful tailor-made prevention strategies for limiting the immense personal and societal burden of stroke in Sub-Saharan Africa (SSA) is contingent on a better understanding of the predisposing risk factors for stroke in the region, which may not necessarily match the nature of stroke risk factors described among other people on other continents. Indeed, the underlying risk factors for stroke in SSA have hitherto not been comprehensively characterized, and currently there is a paucity of expertise, experience, and infrastructure in genomics and environmental research in SSA, to initiate and sustain such investigation. We seek to establish the Stroke Investigative Research and Education Network (SIREN) as a multidisciplinary collaborative research network of investigators in SSA and the United States collectively focused on exploring ways to promote a better understanding of the genetic and environmental risk factors for stroke among people of African ancestry. SIREN will evaluate unique contributors to stroke in SSA and compare these findings with those in a cohort of African American stroke survivors, all while simultaneously building sustainable capacities in phenomics, biobanking, genomics, biostatistics and bioinformatics for future high-level investigation of stroke and other vascular disease entities in SSA. SIREN is comprised of three interwoven Systematic Investigation of Blacks with Stroke (SIBS) projects geared at a comprehensive investigation of stroke: SIBS-Phenomics, SIBS-Genomics and SIBS-Bioinformatics. These projects will be implemented at eight sites in three countries (Nigeria, Ghana, and South Africa), and will leverage prior experience and ongoing collaborations including previous participation in a global stroke epidemiological study, and involvement in two current NIH- funded studies based in SSA. Input from renowned content experts in United States, where the societal burden of stroke has been successfully reduced through proper identification of risk factors and implementation of corresponding preventive strategies will be obtained through systematic network activities. Stroke Investigative Research and Education Network (SIREN)

Public Health Relevance

Stroke is a leading cause of death, disability, dementia, and depression among Black Africans and Black Americans, but the unique factors contributing to stroke occurrence in the former, and the precise reasons underlying a high predilection for stroke among the latter (compared to their Non- Hispanic White counterparts) remain poorly understood. ? SIREN, which is the largest study of stroke in Sub-Saharan Africa (SSA) to date, will first comprehensively investigate the socio-demographic, clinical and genetic characteristics of stroke among Black stroke survivors in SSA, and then compare these findings to those observed in a cohort of Black stroke survivors in the United States. ? SIREN is poised to substantially enhance our understanding of factors that could be addressed to improve stroke outcomes, and possibly other vascular disease entities such as coronary artery disease and chronic kidney disease in SSA; while simultaneously exploring potentially modifiable genetic pathways to stroke risk that may be common to Black Africans and Black Americans. 3

National Institute of Health (NIH)
National Human Genome Research Institute (NHGRI)
Specialized Center--Cooperative Agreements (U54)
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Wiley, Kenneth L
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University of Ibadan College of Medicine
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