Stroke in urban and rural populations in north-east Bulgaria: incidence and case fatality findings from a 'hot pursuit' study

<p>Abstract</p> <p>Background</p> <p>Bulgaria's official stroke mortality rates are higher for rural than urban areas. Official mortality data has indicated that these rates are amongst the highest in Europe. There has been a lack of studies measuring stroke incide...

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Main Authors: Stanoev Marin, Feschieva Nevijana, Kirov Philip, Powles John, Atanasova Virginia
Format: Article
Language:English
Published: BMC 2002-09-01
Series:BMC Public Health
Online Access:http://www.biomedcentral.com/1471-2458/2/24
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author Stanoev Marin
Feschieva Nevijana
Kirov Philip
Powles John
Atanasova Virginia
author_facet Stanoev Marin
Feschieva Nevijana
Kirov Philip
Powles John
Atanasova Virginia
author_sort Stanoev Marin
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Bulgaria's official stroke mortality rates are higher for rural than urban areas. Official mortality data has indicated that these rates are amongst the highest in Europe. There has been a lack of studies measuring stroke incidence in urban and rural populations.</p> <p>Methods</p> <p>We established intensive notification networks covering 37791 residents in Varna city and 18656 residents (55% of them village-dwellers), all aged 45 to 84, in 2 rural districts. From May 1, 2000 to April 30, 2001 frequent contact was maintained with notifiers and death registrations were scanned regularly. Suspected incident strokes were assessed by study neurologists within a median of 8 days from onset.</p> <p>Results</p> <p>742 events were referred for neurological assessment and 351 of these, which met the WHO criteria for stroke, were in persons aged 45 to 84 and were first ever in a lifetime. Incidence rates, standardised using the world standard weights for ages 45 to 84, were 909 (/100000/year) (95% CI 712–1105) and 597 (482–712) for rural and urban males and 667 (515–818) and 322 (248–395) for rural and urban females. Less than half were admitted to hospital (15% among rural females over 65). Twenty-eight day case fatality was 35% (123/351) overall and 48% (46/96) in village residents. The excess case fatality in the villages could not be explained by age or severity.</p> <p>Conclusions</p> <p>Rural incidence rates were over twice those reported for western populations but the rate for urban females was similar to other western rates. The high level and marked heterogeneity in both stroke incidence and case fatality merit further investigation.</p>
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spelling doaj.art-303fdf839491431e9aac056a8f1fb9752022-12-22T03:06:39ZengBMCBMC Public Health1471-24582002-09-01212410.1186/1471-2458-2-24Stroke in urban and rural populations in north-east Bulgaria: incidence and case fatality findings from a 'hot pursuit' studyStanoev MarinFeschieva NevijanaKirov PhilipPowles JohnAtanasova Virginia<p>Abstract</p> <p>Background</p> <p>Bulgaria's official stroke mortality rates are higher for rural than urban areas. Official mortality data has indicated that these rates are amongst the highest in Europe. There has been a lack of studies measuring stroke incidence in urban and rural populations.</p> <p>Methods</p> <p>We established intensive notification networks covering 37791 residents in Varna city and 18656 residents (55% of them village-dwellers), all aged 45 to 84, in 2 rural districts. From May 1, 2000 to April 30, 2001 frequent contact was maintained with notifiers and death registrations were scanned regularly. Suspected incident strokes were assessed by study neurologists within a median of 8 days from onset.</p> <p>Results</p> <p>742 events were referred for neurological assessment and 351 of these, which met the WHO criteria for stroke, were in persons aged 45 to 84 and were first ever in a lifetime. Incidence rates, standardised using the world standard weights for ages 45 to 84, were 909 (/100000/year) (95% CI 712–1105) and 597 (482–712) for rural and urban males and 667 (515–818) and 322 (248–395) for rural and urban females. Less than half were admitted to hospital (15% among rural females over 65). Twenty-eight day case fatality was 35% (123/351) overall and 48% (46/96) in village residents. The excess case fatality in the villages could not be explained by age or severity.</p> <p>Conclusions</p> <p>Rural incidence rates were over twice those reported for western populations but the rate for urban females was similar to other western rates. The high level and marked heterogeneity in both stroke incidence and case fatality merit further investigation.</p>http://www.biomedcentral.com/1471-2458/2/24
spellingShingle Stanoev Marin
Feschieva Nevijana
Kirov Philip
Powles John
Atanasova Virginia
Stroke in urban and rural populations in north-east Bulgaria: incidence and case fatality findings from a 'hot pursuit' study
BMC Public Health
title Stroke in urban and rural populations in north-east Bulgaria: incidence and case fatality findings from a 'hot pursuit' study
title_full Stroke in urban and rural populations in north-east Bulgaria: incidence and case fatality findings from a 'hot pursuit' study
title_fullStr Stroke in urban and rural populations in north-east Bulgaria: incidence and case fatality findings from a 'hot pursuit' study
title_full_unstemmed Stroke in urban and rural populations in north-east Bulgaria: incidence and case fatality findings from a 'hot pursuit' study
title_short Stroke in urban and rural populations in north-east Bulgaria: incidence and case fatality findings from a 'hot pursuit' study
title_sort stroke in urban and rural populations in north east bulgaria incidence and case fatality findings from a hot pursuit study
url http://www.biomedcentral.com/1471-2458/2/24
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