Title: Epidemiology of Stroke in a Rural Community in Kashmir

Authors: Dr Zarka Amin Masoodi, Dr Parvaiz A Shah

 DOI:  http://dx.doi.org/10.18535/jmscr/v4i5.50

Abstract

Background: Stroke is a common neurological disorder and is becoming an important cause of premature death and disability in low income and middle income countries like India. Despite being preventable stroke is increasingly becoming a major health problem. Given the limited information on the prevalence and associated determinants of stroke, the aim of the present study was to assess its prevalence and identify correlates in Kashmir.

Methodology: A cross sectional study was conducted in a rural community of Kashmir. A culturally adapted version of the structured questionnaire developed on the basis WHO protocol was used for sociodemographic and other related data. Individuals with stroke were clinically evaluated with detailed history and thorough clinical examination. The data was statistically analysed using statistical package SPSS Window version 16.0. Chi square test was used for the comparison of categorical variables.

Results: A total of 6960 subjects constituting 51.75% males and 48.25% females participated in the programme. The mean age of participants was 42.62 years. Total of 57 subjects were found to have stroke yielding a prevalence rate of 8.19 per 1000 population. Out of 57 subjects 37 were males and 20 were females showing higher prevalence in males.The age specific prevalence rate for both the genders showed progressive increase in prevalence with advancement of age. Among the factors hypertension was found to be the leading risk factor associated with stroke.

Conclusion: The prevalence of stroke in the present study is higher than previously reported. The low socioeconomic status of the rural study site, and the continued militancy related stress may be the contributing factors for a relatively higher proportion of population at risk of stroke. With hypertension as the leading risk factor, community screening programmes to detect subjects with high blood pressure and. health education measures about awareness of early warning sign of stroke are vital for timely and effective therapy.

Key words: Prevalence, Stroke, Hypertension, Risk factors, Diabetes,

References

    

1.      VL Feigin, CM L Lawes, Bennett DA, Anderson CS. Stroke epidemiology ; a review of population based studies of incidence, prevalence and case fatality in the late 20th century. Lancet Neurol, 2003; 2:43-53.

2.      Babak  Daneshfard, Sadegh Izadi, Abdolhamid Shariat. Mohammad Amin Toudaji, Zahra Beyzavi, Leila Niknam. Epidemiology of stroke in Shiraz, Iran J Neurol 2015; 14(3): 158-163.

3.      Asian Acute Stroke Advisory Panel: Stroke epidemiological data on nine Asian countries. J Med Assoc Thai.2000;83:1-7

4.      Stroke fact sheet India. http:// www.sant.org/updated %20Stroke%20fact %20sheet%202012pdf.

5.      R Bonita, R Beaglehole, Stroke prevention in poor countries. Time for action. Stroke 2007, 38; 2871-2872.

6.      JD Pandian, V Srikanth, SJ Read, AG Thrift. Poverty and Stroke in India. A Time to Act. Stroke2007; 38:3063-3069.

7.      PM Dalal. Burden of Stroke: Indian perspective. International Journal of Stroke2006;1:164-6

8.      PM Dalal. Stroke in India. Japanese circulation J. 1982; 46:621.

9.      E Bhourucha Nadir,Kuruvitla Thomas. 1998. Epidemiology of stroke in India. Neurol J South East Asia 1998; 3:5-8.       

10.  S Razdan, RL Koul, Anil Motta, S Koul. Cerebrovascular Disease in Rural Kashmir, India.1989. Stroke Vol 20, No12:1691-93

11.  Economic Survey 2011-12. Government of Jammu& Kashmir, Directorate of Economics & Statistics Jammu & Kashmir.

12.  World Health Organization. Research protocol for measuring the prevalence of neurological disorders in developing countries. Neuroscience programme Geneva 1981.

13.  AV Chobanian, GL Bakris, HR Black. National heart, Lung and Blood Institute Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure; National High Blood Pressure Education Programme Coordinating Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure: the NC 7 report JAMA,2003;289(19):2560-2572.

14.  Rayaz Jan, DS Jamwal, RK Gupta, P Singh. Incidence and Risk factors of Stroke: A Hospital Based Study in Jammu Province of J&K India Public Health Research 2014, 4(3):104-110.

15.  JD Pandian, P Sudha. Stroke epidemiology and stroke care service in India.JOS Journal of Stroke 2013 Sept;15(3): 128-134.

16.  VI Feigis, CM Lawes, DA Bennett, CS Anderson. Stroke epidemiology a review of population based studies of incidence, prevalence and case fatality in the 20th century. Lancet Neurol 2003; 2:43-53.

17.  Gourie Devi M. Can India afford neuroepidemiology (editorial). Neurol India1987; 35:125-27.

18.  BC Bansal, Prakash C, Jain AC, KRV Brahmanandan. Cerebrovascular disease in young individuals below the age of 40 years. Neurol India1973; 21:11-8.

19.  PM Dalal. Strokes in young and elderly: risk factors and strategies for stroke prevention. J Assoc Physicians  India 1997;45:125-31

20.  SK Das, K Sanyal. Neuroepidemiology of major neurological disorders in rural Bengal. Neurol India1996; 44:47-58.

21.  NE Bharucha, EP Bharucha, AE Bharucha, AV Bhise, BS Shoenberg. Prevalence of stroke in the Parsi community in Bombay. Stroke 1988; 19: 60-2.

22.  KO Enwereji, MC Nwosu, A Oqunnivi, PO Nwani, AL Asomugha, EE Enwereji. Epidemiology of stroke in a rural community in Southeastern Nigeria.Vasc Health Risk Manaq 2014 June 24;10:375-88          

23.  AN Siddiqui, Z Nur, S Mahbub, B Alam, T Miah. Clinical presentation and epidemiology of stroke – a study of hundred cases. J Medicine 2009; 10:86-89.

24.  TK Banerjee, CS Mukherjee, A Sarkhel. Stroke in the urban population of Calcutta-an epidemiological study, Neuroepi-demiology 2001; 20:210-7.

25.  S Bhattacharya, SP Saha, A Basu, SK Das. A 5-year prospective study of incidence, morbidity and mortality profile of stroke in a rural community of Eastern India. J Indian med Assoc 2005; 103:655-9.

26.  PA Wolf. Epidemiology of stroke. In: Mohr JP Choi DW, Grotta,Weir B,Wolf PA, eds: Stroke Pathophysiology, Diagnosis and Management. Philadelphia: Churchill Livingstone, 2004:13-34 

Corresponding Author

Dr Zarka Amin Masoodi

Consultant Medicine

Department of Health & Medical Education, Kashmir India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.