title: Stroke in the rain forest: prevalence in a ribeirinha community and an urban population in the Brazilian Amazon.
abstract: BACKGROUND
  Our objective was to determine the cerebrovascular prevalence in a town in the Brazilian Amazon basin and compare the ribeirinhos (riparians) to the urban population in the same municipality.
  
  
  METHODS
  From May to October 2011, 6,216 residents over 35 years of age in the town of Coari were interviewed using a screening questionnaire, the Stroke Symptom Questionnaire. Cerebrovascular prevalence rates (PRs) from the door-to-door surveillance were calculated according to the location of the home.
  
  
  RESULTS
  Respondent totals were 4,897 in the urban area and 1,028 in the rural area. The crude prevalence of stroke was 6.3% in rural and 3.7% in urban areas with differences maintained after sex and age adjustment. Among stroke cases, the ribeirinhos were those with less access to medical care in comparison to the urban area (32.1 vs. 52.5%, p = 0.01), and a positive association between rural area and no medical care for stroke remained (PR, 1.33; 95% confidence interval, 1.03-1.71), independently of age, sex, education and functional impairment.
  
  
  CONCLUSIONS
  This study provides the first population-based cerebrovascular prevalence comparison between an urban and a rural population in the Amazon rain forest. The PRs were higher in the ribeirinha compared to the urban population in the same municipality.
authors.affiliation: Faculdade de Educação Física e Fisioterapia, Universidade Federal do Amazonas, Manaus, Brazil.
authors.forename: Tiótrefis Gomes
authors.initials: TG
authors.lastname: Fernandes
authors.forename: Isabela Martins
authors.initials: IM
authors.lastname: Benseñor
authors.forename: Alessandra Carvalho
authors.initials: AC
authors.lastname: Goulart
authors.forename: Bruno Mendes
authors.initials: BM
authors.lastname: Tavares
authors.forename: Airlane Pereira
authors.initials: AP
authors.lastname: Alencar
authors.forename: Itamar Souza
authors.initials: IS
authors.lastname: Santos
authors.forename: Paulo Andrade
authors.initials: PA
authors.lastname: Lotufo
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D065947:Rainforest; D012423:Rural Health / Q000706:statistics & numerical data; D020521:Stroke / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014504:Urban Health / Q000706:statistics & numerical data