An estimate of the incidence and prevalence of stroke in Africa: a systematic review and meta-analysis.
An estimate of the incidence and prevalence of stroke in Africa: a systematic review and meta-analysis.
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DOI：
10.1371/journal.pone.0100724
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Adeloye D
中科院分区：
文献类型：
--
作者：
Adeloye D
在非洲，中风正日益成为一个具有挑战性的公共卫生问题，数据的缺乏限制了研究产出，从而限制了对这一负担的反应。这项研究的目的是估计2009年非洲中风的发病率和流行率，以改进该地区对该疾病的政策反应和管理。对Medline、EMBASE和Global Health进行了系统的检索，以寻找最初的基于人群或基于医院的卒中研究。对粗卒中发病率和患病率进行随机效应荟萃分析，所有数据点均采用类似Meta回归的流行病学模型。根据该模型生成的拟合曲线被用来估计2009年联合国人口5岁年龄组中点的非洲中风发病病例和中风幸存者人数。文献检索共产生了1227项研究。来自10个非洲国家的19项研究被选中。据估计，2009年非洲15岁及以上人群新增中风病例48.3万例，相当于每10万人年发病81.2例(13.2-94.9例)。据估计，2009年非洲15岁或15岁以上人群中共有189万中风幸存者，患病率为317.3(314.0-748.2)/100000人口。根据相同的比率计算，2013年的可比数字为1,000(87-625.3)新的中风病例和209万(2，06-4.93)中风幸存者，这表明由于2009年至2013年期间的人口增长和老龄化，中风发病病例和中风幸存者分别增加了10.8%和9.6%。这项综述的结果表明，非洲中风的负担很高，而且仍在增加。需要对中风和其他血管危险因素进行更多的研究，以制定适当的政策和有效的预防和管理措施。
Stroke is increasingly becoming a challenging public health issue in Africa, and the non-availability of data has limited research output and consequently the response to this burden. This study aimed to estimate the incidence and prevalence of stroke in Africa in 2009 towards improved policy response and management of the disease in the region. A systematic search of Medline, EMBASE and Global Health for original population-based or hospital-based studies on stroke was conducted. A random effect meta-analysis was conducted on crude stroke incidence and prevalence rates, and a meta-regression-like epidemiological model was applied on all data points. The fitted curve generated from the model was used to estimate incident cases of stroke and number of stroke survivors in Africa at midpoints of the United Nation population 5-year age groups for the year 2009. The literature search yielded a total of 1227 studies. 19 studies from 10 African countries were selected. 483 thousand new stroke cases among people aged 15 years or more were estimated in Africa in 2009, equivalent to 81.2 (13.2–94.9)/100,000 person years. A total of 1.89 million stroke survivors among people aged 15 years or more were estimated in Africa in 2009, with a prevalence of 317.3 (314.0–748.2)/100000 population. Comparable figures for the year 2013 based on the same rates would amount to 535 thousand (87.0–625.3) new stroke cases and 2.09 million (2.06–4.93) stroke survivors, suggesting an increase of 10.8% and 9.6% of incident stroke cases and stroke survivors respectively, attributable to population growth and ageing between 2009 and 2013. The findings of this review suggest the burden of stroke in Africa is high and still increasing. There is need for more research on stroke and other vascular risk factors towards instituting appropriate policy, and effective preventive and management measures.
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