Enter the text here that is the new abstract information for your application. This section must be no longer than 30 lines of text. 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. 1 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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Special Emphasis Panel (ZHG1-HGR-P (M2))
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Wiley, Kenneth L
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University of Ibadan
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Jenkins, Carolyn; Ovbiagele, Bruce; Arulogun, Oyedunni et al. (2018) Knowledge, attitudes and practices related to stroke in Ghana and Nigeria: A SIREN call to action. PLoS One 13:e0206548
Owolabi, Mayowa O; Sarfo, Fred; Akinyemi, Rufus et al. (2018) Dominant modifiable risk factors for stroke in Ghana and Nigeria (SIREN): a case-control study. Lancet Glob Health 6:e436-e446
Owolabi, Mayowa; Olowoyo, Paul; Popoola, Femi et al. (2018) The epidemiology of stroke in Africa: A systematic review of existing methods and new approaches. J Clin Hypertens (Greenwich) 20:47-55
GBD 2016 Alcohol Collaborators (2018) Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 392:1015-1035
Akinyemi, Rufus O; Sarfo, Fred S; Akinyemi, Joshua et al. (2018) Knowledge, attitudes and practices of West Africans on genetic studies of stroke: Evidence from the SIREN Study. Int J Stroke :1747493018790059
Sarfo, Fred Stephen; Ovbiagele, Bruce; Gebregziabher, Mulugeta et al. (2018) Stroke Among Young West Africans: Evidence From the SIREN (Stroke Investigative Research and Educational Network) Large Multisite Case-Control Study. Stroke 49:1116-1122
Akinyemi, R; Tiwari, H K; Arnett, D K et al. (2018) APOL1, CDKN2A/CDKN2B, and HDAC9 polymorphisms and small vessel ischemic stroke. Acta Neurol Scand 137:133-141
Akinyemi, Rufus O; Owolabi, Mayowa O; Ihara, Masafumi et al. (2018) Stroke, cerebrovascular diseases and vascular cognitive impairment in Africa. Brain Res Bull :
Adeoye, Abiodun M; Ovbiagele, Bruce; Kolo, Philip et al. (2017) Exploring Overlaps Between the Genomic and Environmental Determinants of LVH and Stroke: A Multicenter Study in West Africa. Glob Heart 12:107-113.e5
Bayona, HernĂ¡n; Owolabi, Mayowa; Feng, Wuwei et al. (2017) A systematic comparison of key features of ischemic stroke prevention guidelines in low- and middle-income vs. high-income countries. J Neurol Sci 375:360-366

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