Document Detail


A stepwise approach to stroke surveillance in Brazil: the EMMA (Estudo de Mortalidade e Morbidade do Acidente Vascular Cerebral) study.
MedLine Citation:
PMID:  20636711     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Stroke mortality rates in Brazil are the highest in the Americas. Deaths from cerebrovascular disease surpass coronary heart disease. AIM: To verify stroke mortality rates and morbidity in an area of São Paulo, Brazil, using the World Health Organization Stepwise Approach to Stroke Surveillance. METHODS: We used the World Health Organization Stepwise Approach to Stroke Surveillance structure of stroke surveillance. The hospital-based data comprised fatal and nonfatal stroke (Step 1). We gathered stroke-related mortality data in the community using World Health Organization questionnaires (Step 2). The questionnaire determining stroke prevalence was activated door to door in a family-health-programme neighbourhood (Step 3). RESULTS: A total of 682 patients 18 years and above, including 472 incident cases, presented with cerebrovascular disease and were enrolled in Step 1 during April-May 2009. Cerebral infarction (84.3%) and first-ever stroke (85.2%) were the most frequent. In Step 2, 256 deaths from stroke were identified during 2006-2007. Forty-four per cent of deaths were classified as unspecified stroke, 1/3 as ischaemic stroke, and 1/4 due to haemorrhagic subtype. In Step 3, 577 subjects over 35 years old were evaluated at home, and 244 cases of stroke survival were diagnosed via a questionnaire, validated by a board-certified neurologist. The population demographic characteristics were similar in the three steps, except in terms of age and gender. CONCLUSION: By including data from all settings, World Health Organization stroke surveillance can provide data to help plan future resources that meet the needs of the public-health system.
Authors:
Alessandra C Goulart; Iara R Bustos; Ivana M Abe; Alexandre C Pereira; Ligia M Fedeli; Isabela M Benseñor; Paulo A Lotufo
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  International journal of stroke : official journal of the International Stroke Society     Volume:  5     ISSN:  1747-4949     ISO Abbreviation:  Int J Stroke     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-19     Completed Date:  2010-10-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101274068     Medline TA:  Int J Stroke     Country:  England    
Other Details:
Languages:  eng     Pagination:  284-9     Citation Subset:  IM    
Affiliation:
Hospital Universitario, University of São Paulo, São Paulo, SP, Brazil. agoulart@hu.usp.br
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Aged
Brazil / epidemiology
Cardiovascular Diseases / epidemiology
Data Collection
Female
Hospitalization / statistics & numerical data
Humans
Male
Middle Aged
Population
Population Surveillance / methods*
Questionnaires
Registries
Research Design
Socioeconomic Factors
Stroke / epidemiology*,  mortality
World Health Organization

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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