Conflicts of interest: The authors have nothing to disclose.
Stroke in rural coastal Ecuador: a community-based survey
Article first published online: 26 AUG 2013
© 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization
International Journal of Stroke
Volume 9, Issue 3, pages 365–366, April 2014
How to Cite
Del Brutto, O. H., Santamaría, M., Zambrano, M., Peñaherrera, E., Pow-Chon-Long, F., Del Brutto, V. J., Ochoa, Elio., Valdiviezo, E. and Santibáñez, R. (2014), Stroke in rural coastal Ecuador: a community-based survey. International Journal of Stroke, 9: 365–366. doi: 10.1111/ijs.12102
Funding: This study was partially supported by an unrestricted grant from Universidad the Especialidades Espíritu Santo, Guayaquil – Ecuador.
Clinical Trials.gov identifier: NCT01627600.
- Issue published online: 17 MAR 2014
- Article first published online: 26 AUG 2013
- Manuscript Accepted: 13 MAR 2013
- Manuscript Received: 7 JAN 2013
- Universidad the Especialidades Espíritu Santo, Guayaquil – Ecuador
- developing countries;
- risk factors;
- stroke prevalence
Stroke will be South America's next epidemic. Therefore, information on stroke particularities in the region will help to overcome its impact burden. We evaluated prevalence, pattern of sub-types, and pathogenic mechanisms underlying stroke in Atahualpa, a village representative of rural coastal Ecuador. In a three-phase epidemiologic study, suspected cases were detected by a door-to-door survey (Phase I). Then, neurologists evaluated suspected cases and randomly selected negative persons (Phase II), and confirmed patients underwent complementary exams (Phase III). We found 20 stroke patients (mean age 70 years, 60% men) among 642 persons aged ≥40 years. Stroke prevalence was 31·15‰ that increased with age. Most patients had sub-cortical infarctions associated with leukoaraiosis or microbleeds. Hypertensive arteriolopathy was the most likely mechanism underlying strokes (55% patients). Intracranial arterial lesions were found in 47% cases. Extracranial atherosclerotic lesions or cardiac sources of emboli were not found in any case. Comparison of our findings with a previous survey performed in the same village showed an alarming increase in stroke prevalence (from 14·08‰ in 2003 to 31·15‰ in 2012, P = 0·03).