Stroke epidemiology, prevention, and management strategies at a regional level: Latin America and the Caribbean

-Objective: To evaluate the knowledge about stroke in Caxias do Sul. Method: A closed-ended, self-administered questionnaire was used to assess the knowledge about stroke among residents of Caxias do Sul. In order to verify variables associated to lack of knowledge we defined three main end points: (1) the inability to recognize that stroke is a disease that affects the brain; (2) insufficient knowledge of risk factors; (3) insufficient knowledge of signs and symptoms of acute stroke. Results: A total of 952 subjects answered the questionnaire. Lower income and lower educational level were independent factors associated to inability to recognize that stroke affects the brain. Lower income and being under 50 years old were independent risk factors to lack of knowledge concerning stroke risk factors. Lower educational level was the unique risk factor for insufficient knowledge about stroke warning signs. Conclusion: There is a lack of knowledge about stroke in Caxias do Sul. People with lower socioeconomic status and lower education level should be the targets of educational campaigns.KEY WORDS: stroke, knowledge, risk factors, warning signs, general population. Avaliação de fatores de risco de doença cerebrovascular no sul do BrasilResumo -Objetivo: Avaliar o conhecimento sobre doença cerebrovascular em Caxias do Sul. Método: Um questionário auto-administrado, com questões objetivas, foi utilizado para avaliar o conhecimento sobre doença cerebrovascuar em residentes de Caxias do Sul. A fim de verificar as variáveis associadas à falta de conhecimento, definiram-se três principais desfechos: (1) incapacidade de reconhechecer que o derrame é uma doença que afeta o cérebro; (2) conchecimento insuficiente sobre fatores de risco; (3) conhecimeto insuficiente sobre sinais e sintomas de acidente vascular encefálico. Resultados: Um total de 952 sujeitos responderam o questionário. Menor renda e menor nível socioeconômico foram fatores independentes associados à incapacidade de reconhecer que derrame afeta o cérebro. Menor renda e ter menos que 50 anos de idade foram fatores independentes associados à conchecimento insuficiente sobre fatores de risco para doença cerebrovasculas. Menor nível educacional foi o único fator de risco independente associado à conhecimento insuficiente sobre sinais de alerta do acidente vascular encefálico. Conclusão: Há uma lacuna de conhecimento sobre doença cerebrovascular em Caxias do Sul. Pessoas com menor nível socioeconômico e menor nível educaional deveriam ser o alvo para campanhas educacionais. PALAVRAS-CHAVE: acidente vascular encefálico, conhecimento, fatores de risco, sinais de alerta, população geral. Stroke is a major public health problem and the leading cause of mortality in Brazil 1,2 . Nevertheless, it is still a neglected disease in this country, where a great number of patients does not get the specific treatment because of the delay in the diagnosis and the absence of the recombinant tissue plasminogen activator (rt-PA) in the public hospitals network 2-4 . The awar...

“…Figure shows the rates of correct answers about risk factors of stroke 17 . Only 5% of the subjects had insufficient knowledge about stroke risk factors.…”

Section: Resultsmentioning

confidence: 99%

“…Stroke is the leading cause of death in Brazil 18 and one of the most important causes of disability 17,19 . Since publication of NINDS study in 1995, thrombolysis with rt-PA remains the only authorized treatment for ischemic stroke 20,21 .…”

Section: Discussionmentioning

confidence: 99%

Awareness of stroke risk factors and warning signs in southern Brazil

Falavigna

Teles

Vedana

et al. 2009

mentioning

confidence: 99%

“…However, two-thirds of deaths caused by stroke occur in low and middle-income countries 1 . Currently, stroke can be considered the greatest public health problem in Brazil and in many countries of Latin America 1,2 . Although scarce, Brazilian epidemiological studies show elevated mortality [3][4][5] and high prevalence of sequels in survivors, such as physical disability, post-stroke depression and dementia 6,7 .…”

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confidence: 99%

Prevalence and risk factors for stroke in a population of Southern Brazil

Copstein

Fernandes

Bastos

2013

Stroke is the leading cause of death in many countries of Latin America. Population studies are necessary in this region.Objectives:To evaluate the prevalence of stroke and its risk factors in a population of vulnerable communities of southern Brazil.Methods:Population-based crosssectional study with systematic sampling. Individuals aged 20 and over were included (n=3,391). Individuals with previous diagnosis of stroke or identified by a validate stroke questionnaire were compared with those without stroke in many variables.Results:285 individuals (8.4%) had previous stroke. The group without stroke showed greater average of years of study than the group with stroke (p≪0.001). Multivariable analysis identified as risk factors for stroke (p≪0.05): age from 40 to 59, age from 60 to 79, widowhood, present smoking, previous smoking, hypertension and ischemic heart disease.Conclusion:The findings in this population indicate the need of preventive cost-effective public health policies in Brazil.

“…and the socioeconomic conditions of the regions but also the fact that mortality estimates are based on death certificates, which, in many cases, have low accuracy 2 .…”

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confidence: 99%

Infectious disease is the most common cause of death among stroke patients: two-years of follow-up

Machado

Brucki

Nogueira

et al. 2013

Stroke represents the second common cause of death in adults. Objective It was to evaluate the incidence and causes of mortality after 30 days in a group of patients with an atherothrombotic ischemic stroke who were followed-up for a period of up to two years. Methods We analyzed retrospectively the medical records of patients with ischemic stroke, who did not undergo thrombolysis, of the Santa Marcelina Hospital. We applied a research protocol to obtain information about risk factors and the etiology of death. Results They were followed 337: mean age was 66.6 years (SD 9.05) and 43.9% were females. The mortality rate was 11.9% with most deaths (37.5%) occurring due to infectious causes. The age was correlated with the risk of death, which was five times higher in patients older than 80. Conclusion The most important cause of death after 30 days was infectious disease, and advanced age was predictor of mortality among patients with an atherothrombotic stroke etiology.