Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Specialty Sites
    • COVID-19
    • Practice Current
    • Practice Buzz
    • Without Borders
    • Equity, Diversity and Inclusion
    • Innovations in Care Delivery
  • Collections
    • Topics A-Z
    • Residents & Fellows
    • Infographics
    • Patient Pages
    • Null Hypothesis
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Specialty Sites
    • COVID-19
    • Practice Current
    • Practice Buzz
    • Without Borders
    • Equity, Diversity and Inclusion
    • Innovations in Care Delivery
  • Collections
    • Topics A-Z
    • Residents & Fellows
    • Infographics
    • Patient Pages
    • Null Hypothesis
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

Share

February 12, 2013; 80 (7) Views & Reviews

A systematic evaluation of stroke surveillance studies in low- and middle-income countries

Ayesha Sajjad, Rajiv Chowdhury, Janine F. Felix, M. Arfan Ikram, Shanthi Mendis, Henning Tiemeier, Jonathan Mant, Oscar H. Franco
First published February 11, 2013, DOI: https://doi.org/10.1212/WNL.0b013e318281cc6e
Ayesha Sajjad
From the Department of Public Health and Primary Care (A.S., R.C., J.M., O.H.F.), University of Cambridge, Cambridge, UK; ErasmusAGE, Department of Epidemiology (A.S., J.F.F., O.H.F.), and Departments of Epidemiology (M.A.I., H.T.) and Radiology (M.A.I.), Erasmus MC, Rotterdam, the Netherlands; and the Department of Chronic Diseases and Health Promotion (S.M.), World Health Organization, Geneva, Switzerland.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Rajiv Chowdhury
From the Department of Public Health and Primary Care (A.S., R.C., J.M., O.H.F.), University of Cambridge, Cambridge, UK; ErasmusAGE, Department of Epidemiology (A.S., J.F.F., O.H.F.), and Departments of Epidemiology (M.A.I., H.T.) and Radiology (M.A.I.), Erasmus MC, Rotterdam, the Netherlands; and the Department of Chronic Diseases and Health Promotion (S.M.), World Health Organization, Geneva, Switzerland.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Janine F. Felix
From the Department of Public Health and Primary Care (A.S., R.C., J.M., O.H.F.), University of Cambridge, Cambridge, UK; ErasmusAGE, Department of Epidemiology (A.S., J.F.F., O.H.F.), and Departments of Epidemiology (M.A.I., H.T.) and Radiology (M.A.I.), Erasmus MC, Rotterdam, the Netherlands; and the Department of Chronic Diseases and Health Promotion (S.M.), World Health Organization, Geneva, Switzerland.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
M. Arfan Ikram
From the Department of Public Health and Primary Care (A.S., R.C., J.M., O.H.F.), University of Cambridge, Cambridge, UK; ErasmusAGE, Department of Epidemiology (A.S., J.F.F., O.H.F.), and Departments of Epidemiology (M.A.I., H.T.) and Radiology (M.A.I.), Erasmus MC, Rotterdam, the Netherlands; and the Department of Chronic Diseases and Health Promotion (S.M.), World Health Organization, Geneva, Switzerland.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Shanthi Mendis
From the Department of Public Health and Primary Care (A.S., R.C., J.M., O.H.F.), University of Cambridge, Cambridge, UK; ErasmusAGE, Department of Epidemiology (A.S., J.F.F., O.H.F.), and Departments of Epidemiology (M.A.I., H.T.) and Radiology (M.A.I.), Erasmus MC, Rotterdam, the Netherlands; and the Department of Chronic Diseases and Health Promotion (S.M.), World Health Organization, Geneva, Switzerland.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Henning Tiemeier
From the Department of Public Health and Primary Care (A.S., R.C., J.M., O.H.F.), University of Cambridge, Cambridge, UK; ErasmusAGE, Department of Epidemiology (A.S., J.F.F., O.H.F.), and Departments of Epidemiology (M.A.I., H.T.) and Radiology (M.A.I.), Erasmus MC, Rotterdam, the Netherlands; and the Department of Chronic Diseases and Health Promotion (S.M.), World Health Organization, Geneva, Switzerland.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jonathan Mant
From the Department of Public Health and Primary Care (A.S., R.C., J.M., O.H.F.), University of Cambridge, Cambridge, UK; ErasmusAGE, Department of Epidemiology (A.S., J.F.F., O.H.F.), and Departments of Epidemiology (M.A.I., H.T.) and Radiology (M.A.I.), Erasmus MC, Rotterdam, the Netherlands; and the Department of Chronic Diseases and Health Promotion (S.M.), World Health Organization, Geneva, Switzerland.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Oscar H. Franco
From the Department of Public Health and Primary Care (A.S., R.C., J.M., O.H.F.), University of Cambridge, Cambridge, UK; ErasmusAGE, Department of Epidemiology (A.S., J.F.F., O.H.F.), and Departments of Epidemiology (M.A.I., H.T.) and Radiology (M.A.I.), Erasmus MC, Rotterdam, the Netherlands; and the Department of Chronic Diseases and Health Promotion (S.M.), World Health Organization, Geneva, Switzerland.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Full PDF
Citation
A systematic evaluation of stroke surveillance studies in low- and middle-income countries
Ayesha Sajjad, Rajiv Chowdhury, Janine F. Felix, M. Arfan Ikram, Shanthi Mendis, Henning Tiemeier, Jonathan Mant, Oscar H. Franco
Neurology Feb 2013, 80 (7) 677-684; DOI: 10.1212/WNL.0b013e318281cc6e

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
346

Share

  • Article
  • Figures & Data
  • Info & Disclosures
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Abstract

Objective: Reliable quantification of the burden of stroke in low- and middle-income (LMI) countries is difficult as population-based surveillance reports are scarce and may vary considerably in methodology. We aimed to evaluate all available primary stroke surveillance studies by applying components of a benchmark protocol (WHO STEPwise approach to stroke surveillance) and quantify the reported burden of stroke in LMI settings.

Methods: Electronic databases Medline, Embase, Scopus, and Web of Knowledge were searched for population-based surveillance studies. Studies conducted in the LMI countries that reported on incident stroke were included. Data were extracted from each study using a prestructured format. Information on epidemiologic measures including crude and age-adjusted incidence rates, person-years, admission rates, case fatality rates, death certification, autopsy rates, measures of disability, and other study-specific information, in line with WHO STEPS stroke protocol, were recorded. Age-adjusted incidence rate data of stroke were combined using random-effects meta-analyses.

Results: We identified 7 studies that reported on burden of stroke in 9 LMI countries, including aggregate information from 1,711,372 participants collected over 5,240,923 person-years. The age-adjusted incidence rates across the LMI countries varied widely, with the burden of total first-ever strokes ranging from 41 to 909 events per 100,000 person-years.

Conclusions: Systematic evaluation of all available primary surveillance studies, particularly in the context of WHO STEPS guidelines, indicates inadequate adherence to standardized surveillance methodology in LMI countries. Incorporation of standardized approaches is essential to enhance generalizability and estimate stroke burden accurately in these resource-poor settings.

GLOSSARY

COI=
cost of illness studies;
DALY=
disability-adjusted life-years;
LMI=
low and middle income;
mRS=
modified Rankin Scale

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at www.neurology.org

  • Received May 8, 2012.
  • Accepted October 4, 2012.
  • © 2013 American Academy of Neurology
View Full Text

AAN Members

We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.

Google Safari Microsoft Edge Firefox

Click here to login

AAN Non-Member Subscribers

Click here to login

Purchase access

For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)

Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here 

Purchase
Individual access to articles is available through the Add to Cart option on the article page.  Access for 1 day (from the computer you are currently using) is US$ 39.00.  Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means.  The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use.  Distributing copies (electronic or otherwise) of the article is not allowed.

Disputes & Debates: Rapid online correspondence

No comments have been published for this article.
Comment

NOTE: All authors' disclosures must be entered and current in our database before comments can be posted. Enter and update disclosures at http://submit.neurology.org. Exception: replies to comments concerning an article you originally authored do not require updated disclosures.

  • Stay timely. Submit only on articles published within 6 months of issue date.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • 200 words maximum.
  • 5 references maximum. Reference 1 must be the article on which you are commenting.
  • 5 authors maximum. Exception: replies can include all original authors of the article.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate Disputes & Debates Submission Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
    • Abstract
    • GLOSSARY
    • METHODS
    • RESULTS
    • DISCUSSION
    • AUTHOR CONTRIBUTIONS
    • STUDY FUNDING
    • DISCLOSURE
    • Footnotes
    • REFERENCES
  • Figures & Data
  • Info & Disclosures
Advertisement

Topics Discussed

  • All epidemiology
  • All Cerebrovascular disease/Stroke
  • Screening in epidemiology

Alert Me

  • Alert me when eletters are published
Neurology: 96 (16)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2021 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise