Epidemiology of stroke in a rural community in Southeastern Nigeria

Background: The prevalence and incidence of stroke vary from community to community worldwide. Nonetheless, not much is known about the current epidemiology of stroke in rural Nigeria and indeed Africa. Methods: We carried out a two-phase door-to-door survey in a rural, predominantly low-income, community in Anambra, Southeastern Nigeria. We used a modified World Health Organization (WHO) protocol for detecting neurological diseases in the first phase, and a stroke-specific questionnaire and neurological examination in the second phase. An equal number of sex-and age-matched stroke-negative subjects were examined. Results: We identified ten stroke subjects in the study. The crude prevalence of stroke in rural Nigeria was 1.63 (95% confidence interval [CI] 0.78-3.00) per 1,000 population. The crude prevalence of stroke in males was 1.99 (95% CI 0.73-4.33) per 1,000, while that for females was 1.28 (95% CI 0.35-3.28) per 1,000 population. The peak age-specific prevalence of stroke was 12.08 (95% CI 3.92-28.19) per 1,000, while after adjustment to WHO world population, the peak was 1.0 (95% CI 0.33-2.33) per 1,000. Conclusion: The prevalence of stroke was found to be higher than previously documented in rural Nigeria, with a slightly higher prevalence in males than females. This is, however, comparable to data from rural Africa.