Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan.
BMC Neurol. 2009 Dec 1;9:58. doi: 10.1186/1471-2377-9-58.
The burden of cerebrovascular disease in developing countries is rising sharply. The prevalence of established risk factors of stroke is exceptionally high in Pakistan. However, there is limited data on the burden of stroke and transient ischemic attack (TIA) in South Asia. We report the first such study conducted in an urban slum of Karachi, Pakistan.
Individuals 35 years of age or older were invited for participation in this investigation through simple random sampling. A structured face-to-face interview was conducted using a pre-tested stroke symptom questionnaire in each participant to screen for past stroke or TIA followed by neurological examination of suspected cases. Anthropometric measurements and random blood glucose levels were recorded. Multivariable logistic regression was used to determine the association of vascular risk factors with prevalence of stroke.
Five hundred and forty five individuals (49.4% females) participated in the study with a response rate of 90.8%. One hundred and four individuals (19.1%) were observed to have a prior stroke while TIA was found in 53 individuals (9.7%). Overall, 119 individuals (21.8% with 66.4% females) had stroke and/or TIA. Female gender, old age, raised random blood glucose level and use of chewable tobacco were significantly associated with the prevalence of cerebrovascular disease.
This is the first study demonstrating an alarmingly high life-time prevalence of cerebrovascular disease in Pakistan. Individual and public health interventions in Pakistan to increase awareness about stroke, its prevention and therapy are warranted.
发展中国家的脑血管疾病负担正在急剧上升。在巴基斯坦，已确立的中风风险因素的流行率异常高。然而，南亚地区关于中风和短暂性脑缺血发作（TIA）负担的数据有限。我们报告了在巴基斯坦卡拉奇的一个城市贫民窟进行的第一项此类研究。
通过简单随机抽样邀请 35 岁及以上的个体参与此项调查。在每个参与者中使用经过预测试的中风症状问卷进行结构化的面对面访谈，以筛查过去的中风或 TIA，随后对疑似病例进行神经检查。记录人体测量学测量值和随机血糖水平。多变量逻辑回归用于确定血管危险因素与中风患病率的关联。
545 名个体（49.4%为女性）参与了研究，应答率为 90.8%。104 名个体（19.1%为女性）观察到有既往中风，53 名个体（9.7%）发现有 TIA。总体而言，119 名个体（21.8%，其中 66.4%为女性）患有中风和/或 TIA。女性、年龄较大、随机血糖水平升高和咀嚼烟草的使用与脑血管疾病的患病率显著相关。
这是第一项表明巴基斯坦一生中脑血管疾病患病率高得惊人的研究。需要在巴基斯坦开展个人和公共卫生干预措施，以提高对中风、其预防和治疗的认识。
