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(Stroke. 2001;32:2741.)
© 2001 American Heart Association, Inc.

Original Contributions

ERMANCIA: Epidemiology of Stroke in Martinique, French West Indies

Part I: Methodology, Incidence, and 30-Day Case Fatality Rate

Didier Smadja, MD; Philippe Cabre, MD; Florence May, MD; Jean-Luc Fanon, MD; Patrick René-Corail, MD; Christophe Riocreux, MD; Jean-Christophe Charpentier, MD; Pierre Fournerie, MD; Martine Saint-Vil, MD Jeannine Ketterlé, MD and the ERMANCIA Study Group

From the Departments of Neurology (D.S., P.C., F.M., P.F., M.S-V.), Geriatrics (J-L.F.), Rehabilitation (P.R-C.), and Emergency Medicine (J.K.), University of Fort-de-France, Fort-de-France, Martinique, French West Indies; Méthodologie et Recherche Clinique (J-C.C.), Reims, France; and Caisse Générale de la Sécurité Sociale de la Martinique (C.R.), Fort-de-France, Martinique, French West Indies.

Correspondence to Professor Didier Smadja, MD, Department of Neurology, hôpital Pierre-Zobda-Quitmann, BP 632, 97 261 Fort-de-France Cedex, Martinique, French West Indies. E-mail dsmadja{at}outremer.com

Background and Purpose— The ERMANCIA (Etude Réalisée en Martinique et Centrée sur l’Incidence de Accidents vasculaires cérébraux) study was designed to provide the first comparable epidemiological data on stroke in a black Caribbean population.

Methods— ERMANCIA was a prospective community-based study performed in Martinique (French West Indies) from June 1, 1998, to May 31, 1999. The black at-risk population was approximately 360 000. Multiple sources were used to identify hospitalized and nonhospitalized patients with first-ever stroke.

Results— Five hundred eighty patients (285 men and 295 women; mean±SD age, 71.2±14 years) suffered from a first-ever in a lifetime stroke, yielding a crude annual incidence of 164/100 000 per year (95% CI, 151 to 177). The rates adjusted by age and sex to the French population (1999 census) and to the European population were 202 (95% CI, 185 to 218) and 151 (95% CI, 139 to 164), respectively. Thirty-eight patients (6.5%) were not hospitalized during the acute phase of the stroke; 92.8% had CT scan. Pathological types of strokes were infarction (79.8%, including 23% of lacunar strokes), intracerebral hemorrhage (14.3%), subarachnoid hemorrhage (3.4%), and undetermined (2.4%). The main risk factors for stroke were hypertension (69.1%) and diabetes (29.5%). The 30-day case fatality rate was 19.3% (15.8% for cerebral infarction and 37.3% for intracerebral hemorrhage).

Conclusions— In Martinique, the ERMANCIA population-based study showed a high stroke incidence and a high prevalence of hypertension and diabetes in the stroke population compared with those observed in continental France. Epidemiological data on stroke in African Caribbeans from Martinique are comparable to those reported in blacks from the United States and United Kingdom.

Key Words: blacks • epidemiology • hypertension • stroke

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