Kengne Andre Pascal, Anderson Craig S
The George Institute for International Health, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
Int J Stroke. 2006 Nov;1(4):180-90. doi: 10.1111/j.1747-4949.2006.00064.x.
The looming epidemic of stroke and other chronic non-communicable diseases associated with lifestyle and demographic transitions occurring all over the world is increasingly being acknowledged. However, the significance of these trends in the relatively young populations of the countries comprising Sub-Saharan Africa (SSA) is less certain and considerably overshadowed by attention given to the impact of human immunodeficiency virus and other infectious diseases. We undertook a literature review of the burden of stroke in SSA and provide recommendations for future research. Despite the paucity of high quality studies, the mostly hospital-based data and limited community surveys indicate there to be high and increasing rates of stroke affecting people at much younger ages in SSA than in developed countries. In general, awareness, diagnosis and management of stroke are poor, and the associated case fatality and residual disability are high. As elsewhere, elevated blood pressure is the major determinant of stroke but there are also high rates of strokes related to the complications of rheumatic heart disease and other infections. Given high attributable risks exposures in association with rapid ageing and urbanisation in SSA, the future is not bright. Population-based incidence studies are urgently needed to map the profile and outcome of stroke. Such data would provide the necessary evidence base to improve prevention and treatments for stroke alongside current efforts to bring infectious diseases under control in SSA.
全球范围内，与生活方式和人口结构转变相关的中风及其他慢性非传染性疾病的潜在流行日益受到关注。然而，在撒哈拉以南非洲（SSA）国家相对年轻的人群中，这些趋势的重要性尚不确定，且在很大程度上被对人类免疫缺陷病毒及其他传染病影响的关注所掩盖。我们对SSA地区中风负担进行了文献综述，并为未来研究提供建议。尽管高质量研究匮乏，但大多基于医院的数据和有限的社区调查表明，与发达国家相比，SSA地区中风发病率高且呈上升趋势，发病年龄更小。总体而言，中风的认知、诊断和管理较差，相关病死率和致残率较高。与其他地区一样，血压升高是中风的主要决定因素，但与风湿性心脏病及其他感染并发症相关的中风发生率也很高。鉴于SSA地区快速老龄化和城市化带来的高归因风险暴露，前景不容乐观。迫切需要开展基于人群的发病率研究，以明确中风的情况和转归。这些数据将为改善中风预防和治疗提供必要的证据基础，同时配合目前在SSA地区控制传染病的努力。
