Incidence and 30-day case fatality rate of first-ever stroke in urban Nigeria: The prospective community based Epidemiology of Stroke in Lagos (EPISIL) phase II results
Incidence and 30-day case fatality rate of first-ever stroke in urban Nigeria: The prospective community based Epidemiology of Stroke in Lagos (EPISIL) phase II results
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DOI：
10.1016/j.jns.2013.04.026
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发表时间：
2013-08-15
影响因子：
4.4
通讯作者：
Ojo, Oluwadamilola O.
中科院分区：
文献类型：
--
作者：
Danesi, Mustapha A.;Okubadejo, Njideka U.;Ojo, Oluwadamilola O.
背景：卒中是全球死亡的主要原因，也是全球疾病负担的主要贡献者。虽然从社区角度提供的流行病学信息对于确定特定地区的负担程度和指导卫生资源的公平分配非常重要，但非洲发展中国家卒中发病率的数据却很少。确定尼日利亚城市卒中的当前发病率和短期（30天）病死率（CFR），并提供年龄调整和性别特异性发病率，以便与全球人群进行比较。方法：这项研究是一项前瞻性的基于社区的卒中登记研究，纳入了在所有卫生机构就诊的终生首次住院和非住院卒中病例（医院、顺势疗法护理人员、理疗诊所）。我们的研究不包括因卒中导致的住院前死亡。该研究于2007年1月1日至12月31日在尼日利亚西南部拉各斯州的Surulere地方政府区进行，该地区是一个混合收入的城市地区，根据国家人口委员会的数据，人口约为75万。卒中的定义采用世界卫生组织（WHO）的临床标准。对160例住院脑卒中患者进行随访，确定脑卒中后30天的病死率。189次首次中风，包括112名男性和77名女性（平均+/- SD年龄58.5 +/- 13.5岁），得出粗发病率为25.2/100，000/年（95%置信区间21.6- 28.8）。男性和女性的性别特异率分别为28.3/100 000和21.3/100 000。经年龄调整的发病率为每年每10万人54.08例（根据世卫组织新世界人口调整）。住院率为84.6%，而CFR（住院）为16.2%。结论：尽管年龄和性别相关趋势以及CFR与发达国家相当，但撒哈拉以南非洲城市社区的卒中发病率仍低于新兴经济体和发达经济体。(C)2013爱思唯尔有限公司版权所有。
Background: Stroke is a leading cause of death worldwide and a major contributor to global disease burden. Although epidemiologic information from a community perspective is important in determining the magnitude of the burden in specific regions, and directing equitable distribution of health resources, data on the incidence of stroke in developing countries in Africa are scarce.Aims: To determine the current incidence rate and short-term (30-day) case fatality rate (CFR) of stroke in urban Nigeria, and provide age-adjusted and gender-specific incidence rates to enable comparison with global populations.Methods: The study was a prospective community-based stroke registry enrolling hospitalized and non-hospitalized first-ever in a lifetime stroke cases presenting at all health facilities (hospitals, homeopathic caregivers, physiotherapy clinics) located in the designated community. Pre-hospitalization deaths due to stroke were not included in our study. The study was conducted between January 1st and December 31st 2007 in Surulere Local Government Area of Lagos State, south western Nigeria, a mixed-income urban locality with a population of approximately 750,000 based on data from the National Population Commission. Stroke was defined using the World Health Organization (WHO) clinical criteria. Case fatality at 30-days post stroke was determined at follow-up on 160 hospitalized stroke cases.Results: 189 first-ever strokes, comprised of 112 men and 77 women (mean +/- SD age 58.5 +/- 13.5 years) were documented, giving a crude incidence rate of 25.2 per 100,000 per year (95% confidence interval 21.6- 28.8). The gender-specific rates were 28.3/100,000 and 21.3/100,000 for males and females respectively. The age-adjusted incidence rate was 54.08 per 100,000 per year (adjusted to the WHO New World Population). Hospitalization rate was 84.6%, while the CFR (hospitalized) was 16.2%.Conclusions: The stroke incidence in this urban sub-Saharan African community remains lower than that in emerging and developed economies, although the age- and gender-related trends and CFR are comparable to that in developed countries. (C) 2013 Elsevier B.V. All rights reserved.