Abstract WP199: Higher Stroke Prevalence Rates among Ribeirinhos Compared to Townsmen in the Brazilian Amazon.
There is a lack of epidemiological studies addressing cerebrovascular diseases in remote places as the Amazon river basin. We aimed to calculate the stroke prevalence rates among "ribeirinhos", rural inhabitants who living in riverbanks fishing and extracting fruit and nuts, in the rainforest comparing to townsmen in the same municipality.
Methods: From May to October 2011, 6216 residents aged over 35 years in the of Coari, a municipality that is coverage by the Family Health Program with of 76 000 inhabitants, 35% of them are "ribeirinhos”. We trained all community health workers to carry out a door-to-door application of the “Stroke Symptom Questionnaire” for people over 35 years-old. This tool was applied first for the family for stroke screening and further for the index stroke case, including questions about six key functional impairment. It was previously translated to Portuguese and validated by a neurologist.
Results: From a total of of 4897 respondents of urban area and 1028 "ribeirinhos", we calculated crude prevalence of stroke of 6.3% (95% CI; 5.0-7.7) among the "ribeirinhos" and of 3.7% (95% CI; 3.3-4.1) among townsmen. This difference was maintained after sex-age-adjustment. The female:male prevalence ratio was 1.37 (95% CI; 1.02-1.85) in urban area and the rural area of 0.93 (95% CI; 0.57-1.52). Among stroke suffers, the "ribeirinhos" were those with less access to medical care (32.1% vs. 52.5%, p=0.01) and a lower proportion of stroke survivors requiring help with least 1 activity of daily living (16.9% vs. 39.3%, p=0.001) in comparison to townsmen.
Conclusion: To our knowledge it was the first study that provided a population-based stroke survey in the Amazon rainforest revealing a higher stroke prevalence among "ribeirinhos" compared to townsmen of the same municipality.
- © 2012 by American Heart Association, Inc.