title: Socioeconomic status and stroke prevalence in Morocco: results from the Rabat-Casablanca study.
abstract: BACKGROUND
  Stroke is a growing public health concern in low- and middle- income countries. Improved knowledge about the association between socioeconomic status and stroke in these countries would enable the development of effective stroke prevention and management strategies. This study presents the association between socioeconomic status and the prevalence of stroke in Morocco, a lower middle-income country.
  
  
  METHODS
  Data on the prevalence of stroke and stroke-related risk factors were collected during a large population-based survey. The diagnosis of stroke in surviving patients was confirmed by neurologists while health, demographic, and socioeconomic characteristics of households were collected using structured questionnaires. We used Multiple Correspondence Analysis to develop a wealth index based on characteristics of the household dwelling as well as ownership of selected assets. We used logistic regressions controlling for multiple variables to assess the statistical association between socioeconomic status and stroke.
  
  
  RESULTS
  Our results showed a significant association between household socioeconomic status and the prevalence of stroke. This relationship was non-linear, with individuals from both the poorest (mainly rural) and richest (mainly urban) households having a lower prevalence of stroke as compared to individuals with medium wealth level. The latter belonged mainly to urban households with a lower socioeconomic status. When taking into account the urban population only, we observed that a third of poorest households experienced a significantly higher prevalence of stroke compared to the richest third (OR = 2.06; CI 95%: 1.09; 3.89).
  
  
  CONCLUSIONS
  We conclude that individuals from the most deprived urban households bear a higher risk of stroke than the rest of the population in Morocco. This result can be explained to a certain extent by the higher presence of behavioral risk factors in this specific category of the population, which leads in turn to metabolic and physiological risk factors of stroke, such as obesity, diabetes, and hypertension.
authors.affiliation: CERDI-CNRS, University of Auvergne, Clermont-Ferrand, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Engels
authors.affiliation: CERDI-CNRS, University of Auvergne, Clermont-Ferrand, France.
authors.forename: Quentin
authors.initials: Q
authors.lastname: Baglione
authors.affiliation: CERDI-CNRS, University of Auvergne, Clermont-Ferrand, France.
authors.forename: Martine
authors.initials: M
authors.lastname: Audibert
authors.affiliation: CERDI-CNRS, University of Auvergne, Clermont-Ferrand, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Viallefont
authors.affiliation: Hassan II Aïn Chock University and LASAARE, Casablanca, Morocco.
authors.forename: Fouzi
authors.initials: F
authors.lastname: Mourji
authors.affiliation: Department of Neurology and Neuropsychology, Hôpital des Spécialités and Mohamed V-Souissi University, Rabat, Morocco.
authors.forename: Mustapha
authors.initials: M
authors.lastname: El Alaoui Faris
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009018:Morocco / Q000453:epidemiology; D012923:Social Class; D020521:Stroke / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult