Epidemiology of stroke: findings from a community-based survey in rural Bangladesh

Objectives: This study was designed to determine the epidemiology of stroke in a rural population of Bangladesh. Study design: In a cross-sectional study, we surveyed stroke patients. Methods: The survey was conducted in a rural community of Bangladesh from January 2016 to June 2016. All community members 15 years and older in a surveillance system were included in this study. The Questionnaire for Verifying Stroke-Free Status was used to screen stroke cases at household level which were again examined by the neurologist for confirmatory diagnosis. Results: The prevalence of stroke was 1.96 (95% confidence interval [CI] 1.69-2.26) per 1000 population. The highest prevalence was 9.65 (95% CI 7.42-12.33) per 1000 population, identified among patients aged 65-79 years. Males had higher prevalence (2.38 per 1000 population) than females (1.55 per 1000 population). Of the 24% of patients who had radiological examination (magnetic resonance imaging and computed tomography scan) reports, 17.2% of stroke cases were ischemic, 4.8% were intracerebral, and about 1.1% were subarachnoid. The ratio of infarction to hemorrhage was 2.91. Approximately 67% of patients were diagnosed as hypertensive, and 37% of patients had elevated blood glucose level. While 15% of patients were found to be overweight or obese, 45% of patients had raised blood cholesterol level. More than 10% of patients reported that they had heart disease before the occurrence of stroke. About 40% of patients had the history of tobacco consumption. Conclusions: The prevalence of stroke is higher among elderly and male populations. A significant proportion of patients presented with hypertension and/or diabetes. (C) 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.