This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Nicoletti, A. Articles by Reggio, A. Search for Related Content PubMed PubMed Citation Articles by Nicoletti, A. Articles by Reggio, A. Related Collections Health policy and outcome research Pathology of Stroke Primary and Secondary Stroke Prevention

(Stroke. 2000;31:882.)
© 2000 American Heart Association, Inc.

Original Contributions

Prevalence of Stroke

A Door-to-Door Survey in Rural Bolivia

A. Nicoletti, MD; V. Sofia, MD; S. Giuffrida, MD; A. Bartoloni, MD; F. Bartalesi, MD; M. L. Lo Bartolo, MD; S. Lo Fermo, MD; V. Cocuzza, MD; H. Gamboa, MD; E. Salazar, MD A. Reggio, MD

From the Institute of Neurological Science (A.N., V.S., S.G., M.L.L.B., S.L.F., A.R.), University of Catania, and the Institute of Infectious Diseases (A.B., F.B.), University of Florence, Florence, Italy; and Health District of the Cordillera Province (H.G., E.S.), Camiri, Bolivia.

Correspondence to Alessandra Nicoletti, Istituto di Scienze Neurologiche, Università di Catania, Via Santa Sofia 78, 95125 Catania, Italy. E-mail anicol{at}dimtel.nti.it

Background and Purpose—We carried out a door-to-door survey in rural areas of the Cordillera Province, Santa Cruz Department, Bolivia. A cluster sample of 10 124 inhabitants was selected, and 9955 subjects were screened. The aim was to determine the prevalence of the most common neurological diseases (epilepsy, stroke, parkinsonism, and peripheral neuropathy) in this population.

Methods—We used a modified version of the World Health Organization screening instrument. On screening we found that 1130 subjects tested positive, and 1027 underwent a complete neurological examination. According to the World Health Organization guidelines, we defined stroke as "rapidly developing clinical signs of focal (or global) disturbance of cerebral functions, lasting more than 24 hours or leading to death, with no apparent cause other than that of vascular origin." We considered only first stroke and excluded a possible stroke.

Results—We found 16 subjects (cases) who had experienced 1 complete stroke on prevalent day (November 1, 1994). The crude prevalence of stroke was 174/100 000 (322/100 000 age-adjusted to the world standard population) and 663/100 000 in subjects aged 35 years. Prevalence was >2-fold higher in men than in women (247/100 000 and 99/100 000, respectively) and increased rapidly with age. Seven cases were hospitalized and received specific treatment.

Conclusions—Our crude prevalence is lower compared with rates from developed countries, probably because of a high case fatality rate. Our findings are comparable with those reported from other surveys carried out in rural developing countries.

Key Words: Bolivia • developing countries • epidemiology • stroke

This article has been cited by other articles:

				J. Joubert, L. F. Prentice, T. Moulin, S.-T. Liaw, L. B. Joubert, P.-M. Preux, D. Ware, E. Medeiros de Bustos, and A. McLean Stroke in Rural Areas and Small Communities Stroke, June 1, 2008; 39(6): 1920 - 1928. [Abstract] [Full Text] [PDF]

				O. H. Del Brutto, L. Idrovo, A. Mosquera, C. Navas, R. Santibanez, F. Cuesta, and E. Diaz-Calderon Stroke in rural Ecuador: A three-phase, door-to-door survey Neurology, November 23, 2004; 63(10): 1974 - 1975. [Abstract] [Full Text] [PDF]

				J. J Howard, J. Souchek, and T. C Collins Ischaemic outcomes assessment survey: A pilot study in patients with peripheral arterial disease The British Journal of Diabetes & Vascular Disease, November 1, 2003; 3(6): 424 - 430. [Abstract] [PDF]

				G. Saposnik and O. H. Del Brutto Stroke in South America: A Systematic Review of Incidence, Prevalence, and Stroke Subtypes Stroke, September 1, 2003; 34(9): 2103 - 2107. [Abstract] [Full Text] [PDF]

				J. G. Heckmann, P. L. Kolominsky-Rabas, P. Heuschmann, F. J. Erbguth, B. Neundorfer, J. Galeote, A. Nicoletti, V. Sofia, S. Giuffrida, M. L. L. Bartolo, et al. Low Incidence of Stroke in the Chiquitanos Tribe in the Bolivian Lowlands Response Stroke, September 1, 2000; 31 (9): 2266 - 2278. [Full Text] [PDF]