Connor Myles D, Walker Richard, Modi Girish, Warlow Charles P
Division of Neurology, Department of Neuroscience, University of the Witwatersrand, Johannesburg, South Africa.
Lancet Neurol. 2007 Mar;6(3):269-78. doi: 10.1016/S1474-4422(07)70002-9.
Sub-Saharan Africa is undergoing epidemiological transition. Stroke and other vascular diseases increasingly contribute to the burden of disease. There are no systematic reviews of stroke mortality, prevalence, incidence, and case fatality. We combined a thorough search and critical assessment of the published research. Stroke mortality is as high, perhaps higher, than in high-income regions and increases with age in sub-Saharan Africa as in high-income countries, but the absolute number of stroke deaths remains low. There are no adequate community-based stroke incidence studies. Hospital-based incidence is lower than in high-income regions, but higher in young people, possibly due to hospital admission bias. There are no community-based data on case fatality, but hospital-based case fatality is higher than elsewhere. The prevalence of stroke is lower than in high-income regions, but disabling stroke is as prevalent. As the region develops economically, the incidence of stroke and other vascular diseases will increase unless interventions are implemented. Only community-based incidence studies will accurately reveal the burden of stroke.
撒哈拉以南非洲正在经历流行病学转变。中风和其他血管疾病对疾病负担的影响日益增加。目前尚无关于中风死亡率、患病率、发病率和病死率的系统综述。我们对已发表的研究进行了全面检索和批判性评估。撒哈拉以南非洲的中风死亡率与高收入地区相当，甚至可能更高，并且与高收入国家一样，随年龄增长而上升，但中风死亡的绝对数量仍然较低。目前尚无足够的基于社区的中风发病率研究。基于医院的发病率低于高收入地区，但在年轻人中较高，这可能是由于医院入院偏倚所致。目前尚无基于社区的病死率数据，但基于医院的病死率高于其他地区。中风的患病率低于高收入地区，但致残性中风的患病率相当。随着该地区经济的发展，除非实施干预措施，中风和其他血管疾病的发病率将会增加。只有基于社区的发病率研究才能准确揭示中风的负担。
