Stroke in Maputo Central Hospital, Mozambique 2019: A glimpse of epidemic or endemicity?

Y Baduro,J Arroz,L Elder,C Casas,N Arroz,N Omer,H Buque,D Vaz,F Sebastiao,J Baco

doi:10.1016/j.jns.2019.10.741

Abstract

Although not a communicable disease, the term “stroke epidemic” is being used widely in the literature. The “epidemic” of stroke might be due to over the time social transmission of unhealthy activities such as unhealthy diet, physical inactivity, and smoking. The aim of this study is to determine the endemic/epidemic pattern of stroke in Maputo Central Hospital in the first semester of 2019. A cross-sectional hospital-based study was carried out collecting secondary data (registered cases) from hospitalized patients with stroke. Data from 2014–18 were used to generate the epidemic thresholds. Four threshold epidemic detection methods were used: mean + 2SD; C-SUM; C-SUM + 1.96SD; and the 3rd quartile. Data from January to June 2019 were used to analyze the 2019 trend over the thresholds. An epidemic pattern of stroke was observed during the first semester of 2019 when 3rd quartile and C-SUM threshold epidemic method was used. This epidemic pattern of stroke was not observed when mean+2SD and C-SUM+1.96SD threshold epidemic method was used. A relatively stable pattern of stroke occurrence with high registered cases was observed during the study period. Stroke is an endemic disease for the Maputo Central Hospital, with an epidemic pattern during the first semester of 2019. Adoption of 3rd quartile threshold methods for stroke surveillance might well add value for the control of the stroke epidemics.

Highlights

Stroke is a noncommunicable disease (NCD) currently recognized as a major leading cause for reduced life expectancy at birth globally for men and women
The C-SUM+1.96SD and mean+2SD methods have the highest monthly thresholds comparing to C-SUM and 3rd quartile methods
An epidemic pattern of stroke was observed during the first semester of 2019 when 3rd quartile and C-SUM threshold epidemic method was used

Summary

Introduction

Stroke (cerebrovascular accident) is a noncommunicable disease (NCD) currently recognized as a major leading cause for reduced life expectancy at birth globally for men and women. According to World Health Organization, stroke mortality rates are higher in males, and the reduced life expectancy of males compared with that of females is not due to a single or a small number of causes [1]. Not a communicable disease, the term “stroke epidemic” is being used widely in the literature [2 6]. Epidemic is defined as the occurrence in a region or community of a number of excess cases, in relation to what would normally be expected; diseases are called endemic when in a geographical area or population group it presents a relatively stable pattern of occurrence with high incidence or prevalence [7]

Results

Discussion

Conclusion