Door-to-door capture of incident and prevalent stroke cases in Durango, Mexico: the Brain Attack Surveillance in Durango Study.
Door-to-door capture of incident and prevalent stroke cases in Durango, Mexico: the Brain Attack Surveillance in Durango Study.
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DOI：
10.1161/strokeaha.110.592592
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发表时间：
2011-03
期刊：
影响因子：
8.3
通讯作者：
Morgenstern LB
中科院分区：
文献类型：
--
作者：
Cantu-Brito C;Majersik JJ;Sánchez BN;Ruano A;Becerra-Mendoza D;Wing JJ;Morgenstern LB
Stroke incidence and prevalence estimates in developing countries should include stroke cases not presenting to hospital. We performed door-to-door stroke case ascertainment in Durango Municipality, Mexico to estimate stroke incidence and prevalence, and to determine the error made by only ascertaining hospital cases. Between September 2008 and March 2009, 1996 housing units were randomly sampled to screen for stroke in Durango Municipality residents ≥35 years of age. Field workers utilized a validated screening tool. Those screening positive were referred to a neurologist for history and examination and if confirmed, a head CT scan. Prevalence and cumulative incidence from the door-to-door surveillance were calculated and compared with previously reported hospitalization rates during the same defined time. Respondents included 2437 subjects from 1419 homes. The refusal rate was 3.8%. Twenty subjects had verified or probable stroke. The prevalence of probable or verified stroke was 7.7/1000 (95% CI: 4.3/1000, 11.2/1000). Five patients had a stroke during the time of the hospital surveillance, yielding a cumulative incidence of 232.3/100,000 (95% CI: 27.8, 436.9). Two of the 5 cases were captured by door-to-door surveillance but not by hospital surveillance. This study provides the first community-based stroke prevalence and incidence estimates in Mexico. The wide confidence intervals, despite the large number of surveyed housing units, suggest the need for more advanced sampling strategies for stroke surveillance in the developing world.
