Characteristics of Included Studies.

Young adults in the Middle East and North Africa (MENA) region are experiencing a high prevalence of risk factors for stroke, such as obesity, diabetes, hypertension and dyslipidemia. This systematic review and meta-analysis aimed to estimate the prevalence of stroke in this important demographic within the MENA region. Comprehensive searches of PubMed, Scopus, Embase, and CINAHL databases were conducted for observational studies published up to 2024. Eligible studies reported stroke prevalence in individuals aged 15–45 years within the MENA region. Prevalence estimates for young adults were pooled using the random effects model after using the Freeman-Tukey double-arcsine transformation. Heterogeneity was assessed using the I² statistic, and publication bias was evaluated using Doi plots. The risk of bias was assessed using the tool developed by Hoy. Overall, fourteen studies from Saudi Arabia, Iran, Egypt, Morocco, Lebanon, and Qatar, encompassing a total of 3,815,317 individuals, were included. The highest prevalence of stroke among young adults was reported in Saudi Arabia (0.167%, 95%CI 0.00–0.840), and the lowest prevalence was reported in Iran (0.011%, 95%CI 0.000–0.034). After meta-analysis, the overall prevalence of stroke among young adults was 0.036% (95%CI 0.024–0.051, I² = 96.9%), equivalent to 3.6 per 10,000. Stroke prevalence was comparable between females (0.038%, 95%CI 0.019–0.061, I2 = 94.8%) and males (0.037%, 95%CI 0.017–0.064, I2 = 96.2%). The prevalence more than doubled from 0.022% (95%CI 0.009%-0.041%, I2 = 96.2%) before 2015 to 0.072% (95%CI 0.034%-0.122%, I2 = 98.0%) after the year 2015. Ischemic stroke was the predominant subtype, accounting for 79.3% (95%CI 77.4–81.1) of the cases. While the prevalence of stroke in young adults in the MENA region is lower than in high-income regions, it appears to be increasing. There is a need for more robust data on stroke prevalence in the region.
Registration
The protocol for this systematic review and meta-analysis was registered on the International Prospective Register of Systematic Reviews (PROSPERO) under the registration ID. CRD42024504772.