A systematic evaluation of stroke surveillance studies in low- and middle-income countries

Sajjad, Ayesha; Chowdhury, Rajiv; Felix, Janine F.; Ikram, M. Arfan; Mendis, Shanthi; Tiemeier, Henning; Mant, Jonathan; Franco, Oscar H.

doi:10.1212/wnl.0b013e318281cc6e

Cited by 32 publications

(26 citation statements)

References 18 publications

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“…LMICs [9]. Previous reviews had little representation of LMICs [44], others were based on regional [6,8,[45][46][47][48], country [28,49,50] or population-specific analysis [28,49,50].…”

Section: Discussionmentioning

confidence: 99%

“…Improved stroke surveillance and care, as well as for better management of the underlying risk factors, primarily undetected or uncontrolled high blood pressure (HBP) are needed. Though there are existing reviews that had looked at prevalence of stroke in LMICs and regions such as Africa and Latin America [6][7][8][9], to the best of our knowledge there is no recent attempt to compile studies on stroke prevalence across different geographic regions in LMICs. Since the publication of these reviews, there have been an increasing number of new studies from these regions.…”

mentioning

confidence: 99%

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Stroke survivors in low- and middle-income countries: A meta-analysis of prevalence and secular trends

Ezejimofor

Chen

Kandala

et al. 2016

Journal of the Neurological Sciences

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Northumbria University has developed Northumbria Research Link (NRL) to enable users to access the University's research output. Copyright © and moral rights for items on NRL are retained by the individual author(s) and/or other copyright owners. Single copies of full items can be reproduced, displayed or performed, and given to third parties in any format or medium for personal research or study, educational, or not-for-profit purposes without prior permission or charge, provided the authors, title and full bibliographic details are given, as well as a hyperlink and/or URL to the original metadata page. The content must not be changed in any way. Full items must not be sold commercially in any format or medium without formal permission of the copyright holder. The full policy is available online: http://nrl.northumbria.ac.uk/policies.html This document may differ from the final, published version of the research and has been made available online in accordance with publisher policies. To read and/or cite from the published version of the research, please visit the publisher's website (a subscription may be required.) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 Overall, 101 eligible community-based studies were included in the meta-analysis.The pooled crude prevalence of stroke survivors was highest in Latin America and Caribbean (21.2 per 1000, 95% CI 13.7 to 30.29) but lowest in sub-Saharan Africa (3.5 per 1000, 95% CI 1.9 to 5.7). Steepest increase in stroke prevalence occurred in low-income countries, increasing by 14.3% annually while the lowest increase occurred in lower-middle income countries (6% annually), and for every 10 years increase in participants' mean age, the prevalence of stroke survivors increases by 62% (95% CI 6% to 147%). ConclusionThe prevalence estimates of stroke survivors are significantly different across LMICs in both magnitude and secular trend. Improved stroke surveillance and care, as well as for better management of the underlying risk factors, primarily undetected or uncontrolled high blood pressure (HBP) are needed. Though there are existing reviews that had looked at prevalence of stroke in LMICs and regions such as Africa and Latin America [6][7][8][9], to the best of our knowledge there is no recent attempt to compile studies on stroke prevalence across different geographic regions in LMICs. Since the publication of these reviews, there have been an increasing number of new studies from these regions. This study therefore, aimed to provide more accurate estimates on the prevalence of stroke survivors and secular trends in LMICs in order to inform decision regarding policy responses and public health intervention across many geographic regions, socioeconomic and populations' subgroups. Methods Protocol and registrationThis systematic review rational and methods were specified ...

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“…LMICs [9]. Previous reviews had little representation of LMICs [44], others were based on regional [6,8,[45][46][47][48], country [28,49,50] or population-specific analysis [28,49,50].…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Stroke survivors in low- and middle-income countries: A meta-analysis of prevalence and secular trends

Ezejimofor

Chen

Kandala

et al. 2016

Journal of the Neurological Sciences

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“…A study synthesizing STEPS Stroke surveillance at 9 sites in India, Iran, Mozambique, Nigeria, and Russia showed that STEPS Stroke surveillance is possible and feasible in low-resource settings [65]. However, a systematic evaluation of 7 STEPS Stroke surveillance studies in 9 LMIC indicated inadequate adherence to standardized surveillance methodology [66]. …”

Section: Strokementioning

confidence: 99%

Management of NCD in Low- and Middle-Income Countries

et al. 2014

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Noncommunicable disease (NCD), comprising cardiovascular disease, stroke, diabetes, and chronic obstructive pulmonary disease, are increasing in incidence rapidly in low- and middle-income countries (LMICs). Some patients have access to the same treatments available in high-income countries, but most do not, and different strategies are needed. Most research on noncommunicable diseases has been conducted in high-income countries, but the need for research in LMICs has been recognized. LMICs can learn from high-income countries, but they need to devise their own systems that emphasize primary care, the use of community health workers, and sometimes the use of mobile technology. The World Health Organization has identified “best buys” it advocates as interventions in LMICs. Non-laboratory-based risk scores can be used to identify those at high risk. Targeting interventions to those at high risk for developing diabetes has been shown to work in LMICs. Indoor cooking with biomass fuels is an important cause of chronic obstructive pulmonary disease in LMICs, and improved cookstoves with chimneys may be effective in the prevention of chronic diseases.

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“…It is projected that by 2,050 80% of strokes will occur in developing countries [2] . However, data on the burden of stroke from these countries are sparse [3] .…”

Section: Introductionmentioning

confidence: 99%

High Prevalence of Stroke in Rural Gadchiroli, India: A Community-Based Study

et al. 2016

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Background: In the near future, a majority of strokes are projected to occur in developing countries. However, population-level information on the prevalence of stroke from rural areas of developing countries, including India, is rare. We estimated the prevalence of stroke in a rural area of one of the most underdeveloped districts of India. Methods: Trained surveyors conducted a house-to-house survey using a validated screening questionnaire in a well-defined population of 45,053 living in 39 villages in a demographic surveillance site in Gadchiroli district. A trained physician and a neurologist evaluated screen-positive patients and diagnosed stroke using the World Health Organization's criteria. Results: In the screened population, 175 patients had stroke. The mean age of patients with stroke was 60.9 ± 14.7 years and 32.5% were women. The crude prevalence rate of stroke was 388.43 (95% CI 335.04-450.33) and the age-standardized prevalence rate of stroke was 535.58 (95% CI 492.41-583.01) per 100,000 population. The crude prevalence rate of stroke was significantly higher among men than among women (520 vs. 255/100,000 population, p < 0.05). Conclusion: In this prevalence study, conducted after a gap of 20 years in rural India, the prevalence of stroke was high and was more than twice the prevalence reported from the previous study. The prevalence was double among men compared to women. Stroke is emerging as a public health priority in rural India.

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A systematic evaluation of stroke surveillance studies in low- and middle-income countries

Cited by 32 publications

References 18 publications

Stroke survivors in low- and middle-income countries: A meta-analysis of prevalence and secular trends

Stroke survivors in low- and middle-income countries: A meta-analysis of prevalence and secular trends

Management of NCD in Low- and Middle-Income Countries

High Prevalence of Stroke in Rural Gadchiroli, India: A Community-Based Study

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