Incidence and Prevalence of Stroke and its Risk Factors in the Philippines: A Systematic Review

Abstract

Background. Various epidemiologic studies reported different stroke incidence and prevalence rates in the Philippines. Thus, there is a need to synthesize existing information on these indicators to depict more accurate evidence on the burden on stroke in the country.Objective. The objective of this systematic review is to provide evidence on the incidence and prevalence of stroke in the Philippines, as well as its associated risk factors.Methods. PubMed and HERDIN were searched for available full-text Philippine epidemiologic studies on stroke incidence and prevalence, whether population or hospital-based, and its associated risk factors. We used three tools for risk of bias assessment, namely, the Newcastle Ottawa Scale for cohort studies, the Quality assessment checklist of Hoy et al. for cross-sectional prevalence studies, and the AXIS tool for general cross-sectional studies.Results. A total of 14 studies were included in this review. Based on these studies, the national stroke incidence rate ranged from 3.95% to 5.61%, while the national stroke prevalence rate ranged from 0.486% to 6.0%. Hypertension remains the commonly reported risk factor of stroke alongside diabetes, smoking, and high cholesterol level. Conclusions.Despite limitations, we were able to perform a complete assessment of the risk of bias in included studies which provide information on the studies with reliable information. Based on this systematic review, there is variability on data and limited studies on the national epidemiology of stroke in the Philippines. It is recommended that the national government consider establishing a system such as a national registry for better data collection and analysis.

Strengthening stroke prevention and awareness in the Philippines: a conceptual framework

“…While community health center stroke symptom awareness is an integral part of the proposed program, we acknowledge that attendance to this alone may not be sufficient to make an overall substantial impact on stroke prevention. A recent systematic review revealed that hypertension is still the frequently cited risk factor for stroke, along with diabetes, smoking, and elevated levels of cholesterol (9). Furthermore, in a large prospective cohort study of 155,722 individuals, approximately 70% of cardiovascular disease (defined as myocardial infarction, stroke and heart failure) cases, were found to be associated with modifiable risk factors (10).…”

“…Despite not having a unified national registry for stroke cases, the national stroke incidence rate ranged from 3.95 to 5.61%. [9] Under the framework of the building blocks of the health system by the WHO, an extensive review article by Collantes et al highlighted the several gaps in stroke care in the Philippines (11). Among these is targeted improving patient awareness of stroke symptoms along with prompt emergency medical services (EMS) dispatch.…”

Safety of edaravone in acute ischemic stroke: A systematic review and meta-analysis

“…1 It is a disease with a high public health and financial burden, particularly in lowincome countries. [2][3][4] At present, the only proven treatments to recover brain tissue at risk in acute ischemic stroke are intravenous thrombolysis with recombinant tissue plasminogen activator (rTPA, or alteplase) within 4.5 hours of ischemic stroke onset 5,6 , and more recently endovascular thrombectomy up to 24 hours. 7,8 Beyond these time windows, only medication for secondary stroke prevention can be given.…”

“…9 Moreover, access to these essential treatments may be limited especially in low-income countries due to social barriers to healthcare. 2,3 It is therefore beneficial to study other promising and easily accessible strategies to improve stroke recovery such as neuroprotective agents.…”