ERMANCIA: Epidemiology of Stroke in Martinique, French West Indies: Part I: methodology, incidence, and 30-day case fatality rate.
OBJECTIVE
The ERMANCIA (Etude Réalisée en Martinique et Centrée sur l'Incidence de Accidents vasculaires cérébraux) study was designed to provide the first comparable epidemiological data on stroke in a black Caribbean population.


METHODS
ERMANCIA was a prospective community-based study performed in Martinique (French West Indies) from June 1, 1998, to May 31, 1999. The black at-risk population was approximately 360 000. Multiple sources were used to identify hospitalized and nonhospitalized patients with first-ever stroke.


RESULTS
Five hundred eighty patients (285 men and 295 women; mean+/-SD age, 71.2+/-14 years) suffered from a first-ever in a lifetime stroke, yielding a crude annual incidence of 164/100 000 per year (95% CI, 151 to 177). The rates adjusted by age and sex to the French population (1999 census) and to the European population were 202 (95% CI, 185 to 218) and 151 (95% CI, 139 to 164), respectively. Thirty-eight patients (6.5%) were not hospitalized during the acute phase of the stroke; 92.8% had CT scan. Pathological types of strokes were infarction (79.8%, including 23% of lacunar strokes), intracerebral hemorrhage (14.3%), subarachnoid hemorrhage (3.4%), and undetermined (2.4%). The main risk factors for stroke were hypertension (69.1%) and diabetes (29.5%). The 30-day case fatality rate was 19.3% (15.8% for cerebral infarction and 37.3% for intracerebral hemorrhage).


CONCLUSIONS
In Martinique, the ERMANCIA population-based study showed a high stroke incidence and a high prevalence of hypertension and diabetes in the stroke population compared with those observed in continental France. Epidemiological data on stroke in African Caribbeans from Martinique are comparable to those reported in blacks from the United States and United Kingdom.
Smadja
D
D
Department of Neurology, University of Fort-de-France, Fort-de-France, Martinique, French West Indies. dsmadja@outremer.com
Cabre
P
P
May
F
F
Fanon
J L
JL
René-Corail
P
P
Riocreux
C
C
Charpentier
J C
JC
Fournerie
P
P
Saint-Vil
M
M
Ketterlé
J
J
D000293:Adolescent; D000328:Adult; D000349:Africa / Q000208:ethnology; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D004812:Epidemiologic Methods; D015340:Epidemiologic Research Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008395:Martinique / Q000453:epidemiology; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data