Prevalence and Risk Factors of Stroke in Bangladesh: A Nationwide Population-Based Survey

Background This community survey was conducted to estimate the prevalence of stroke and its associated common risk factors among the Bangladeshi population. Methods This was a population-based cross-sectional study, carried out in 8 administrative divisions and 64 districts to estimate the prevalence of stroke throughout the country. The study adopted a two-stage cluster random sampling approach. The calculated sample size was 25,287. A semi-structured questionnaire was used to identify suspected stroke patients who were subsequently confirmed by consultant neurologists. Result In the first stage, Interviewers identified 561 respondents as suspected stroke in 64 districts. Of the 25,287 respondents, 54.9% were male. The mean age was 39.9 years. In the second stage of the study; among all the respondents, 288 were confirmed as stroke patients which provided a prevalence of 11.39 per 1000 population. The highest stroke prevalence (14.71 per thousand) was found in the Mymensingh division and the lowest (7.62 per thousand) found in the Rajshahi division. It was 30.10 per thousand in the age group of more than 60 years. The prevalence of stroke among males was twice that of females (13.62 versus 8.68 per thousand). The prevalence was slightly higher in rural areas (11.85 versus 11.07). Out of a total of 288 cases, 79.7% (213) patients had an ischemic stroke, 15.7% (42) had hemorrhagic, and 4.6% (12) were diagnosed as subarachnoid hemorrhage. The majority of the stroke patients had hypertension (79.2%), followed by dyslipidemia (38.9%), tobacco use in any form (37.2%), diabetes (28.8%), ischemic heart disease (20.1%). Conclusion We have found a stroke prevalence of 11.39 per 1000 population, the highest being in the Mymensingh division. The prevalence was much higher in the elderly and male population. More than three fourth had an ischemic stroke. Hypertension, dyslipidemia, tobacco use, diabetes, ischemic heart disease are the most common risk factors observed among stroke patients. Summary Box Already Known: ▪ The prevalence of stroke in Bangladesh was found to be 3 per thousand. ▪ Hypertension, diabetes, dyslipidemia, smoking, and ischemic heart disease were common risk factors. New Findings: ▪ This is the first-ever nationwide survey in Bangladesh that revealed a stroke prevalence of 11.39 per thousand. ▪ There was a wide regional variation of stroke prevalence. ▪ The prevalence was twice among males. Impact of the study result: ▪ The study result will help the policymakers in deciding what to do for which regions of this country to handle the stroke burden. ▪ It will also help the clinicians to identify common risk factors among stroke patients.