Stroke Prevalence in a Poor Neighbourhood of SãO Paulo, Brazil: Applying a Stroke Symptom Questionnaire

Abstract

Brazil has one of the highest stroke mortality rates in the world, these rates are most endemic in the poor. We verified the prevalence of stroke in a deprived neighbourhood in the city of São Paulo, Brazil and compared it with other surveys worldwide. A questionnaire with six questions concerning limb and facial weakness, articulation, sensory disturbances, impaired vision, and past diagnosis of stroke was completed door-to-door in a well-defined area of 15,000 people. Questionnaires were considered positive when a participant answered two or more questions about stroke symptoms or the presence of stroke being confirmed by a physician, or at least three questions in the positive, even if not confirmed by a doctor. Of the 4496 individuals over 35-years old living in the area, 243 initially screened positive for stroke. The age-adjusted prevalence rate for men was 4·6% (95% confidence interval 3·5-5·7). For women, the prevalence rate was 6·5% (95% confidence interval 5·5-7·5); when considering only one question, the rate was 4·8% (95% confidence interval 3·9-5·7). The most commonly reported symptoms were limb weakness and sensory disturbances. Hypertension and heart disease were the conditions most commonly associated with previous stroke. Stroke prevalence rates were higher in this poor neighbourhood compared with other surveys.