An Epidemiological Study of Stroke Hospitalizations in Maputo, Mozambique A High Burden of Disease in a Resource-Poor Country
An Epidemiological Study of Stroke Hospitalizations in Maputo, Mozambique A High Burden of Disease in a Resource-Poor Country
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DOI：
10.1161/strokeaha.110.594275
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发表时间：
2010-11-01
期刊：
影响因子：
8.3
通讯作者：
Lunet, Nuno
中科院分区：
文献类型：
--
作者：
Damasceno, Albertino;Gomes, Joana;Lunet, Nuno
背景和目的——在高收入国家，中风已经是造成死亡和残疾的一个主要原因，预计撒哈拉以南非洲的中风负担也将很高。然而，资源贫乏的国家缺乏具体的中风数据。我们研究了莫桑比克马普托因中风住院的发病率、特征和短期后果。方法：根据世界卫生组织卒中监测项目的逐步方法，前瞻性地收集了马普托任何一家医院收治的所有当地卒中患者在12个月内的综合数据。还研究了残疾水平（出院前和出院后）和短期病死率（住院和28天）。结果：总体而言，登记中心捕获了651例新卒中事件（平均年龄59.1±13.2岁，男性占53%），其中601例经CT扫描（83.4%）或尸检（8.9%）确诊。粗略和调整后的（世界参考人口）年卒中发病率分别为148.7 / 10万和260.1 / 10万，年龄为25岁。其中531例（81.6%）为首次卒中事件，其中254例为缺血性卒中（42.0%），217例为脑出血（36.1%）。入院前561例（86.2%）患者有高血压，271例（41.6%）患者在入院前24小时有高血压症状。住院和28天病死率分别为33.3%和49.6%（出血性卒中为72.3%）。入院前几乎没有残疾，28天370名幸存者中有64.4%患有中度至重度残疾。结论：马普托与脑卒中相关的疾病负担很高，强调了在流行病学转型的发展中国家进行初级预防和提高护理标准的重要性。(中风。2010;41:2463 - 2469)。
Background and Purpose-Already a major cause of death and disability in high-income countries, the burden of stroke in sub-Saharan Africa is also expected to be high. However, specific stroke data are scarce from resource-poor countries. We studied the incidence, characteristics, and short-term consequences of hospitalizations for stroke in Maputo, Mozambique.Methods-Over 12 months, comprehensive data from all local patients admitted to any hospital in Maputo with a new stroke event were prospectively captured according to the World Health Organization's STEPwise approach to stroke surveillance program. Disability levels (pre- and posthospital discharge) and short-term case-fatality (in-hospital and 28 days) were also studied.Results-Overall, 651 new stroke events (mean age 59.1 +/- 13.2 years and 53% men) were captured by the registry with 601 confirmed by CT scan (83.4%) or necropsy (8.9%). Crude and adjusted (world reference population) annual incidence rates of stroke were 148.7 per 100 000 and 260.1 per 100 000 aged >= 25 years, respectively. Of these, 531 (81.6%) represented a first-ever stroke event comprising 254 ischemic (42.0%) and 217 (36.1%) an intracerebral hemorrhage. Before admission, 561 patients (86.2%) had hypertension and 271 (41.6%) had symptoms for >24 hours. In-hospital and 28-day case-fatality were 33.3% and 49.6% (72.3% for hemorrhagic stroke), respectively. From almost no preadmission disability, 64.4% of 370 survivors at 28 days had moderate-to-severe disability.Conclusions-The burden of disease associated with stroke is high in Maputo, emphasizing the importance of primary prevention and improvement of the standards of care in a developing country under epidemiological transition. (Stroke. 2010;41:2463-2469.)