Prevalence of Stroke and Its Risk Factors in Urban Sri Lanka: Population-Based Study.
OBJECTIVE
Stroke is a leading cause of disability and death worldwide. In the absence of published population-based prevalence data, we investigated the prevalence and risk factors of stroke in a population of varying urbanization in Sri Lanka.


METHODS
A population-based, cross-sectional study was conducted among 2313 adults aged ≥18 years residing in Colombo, selected using a multistage, probability proportionate-to-size, cluster sampling technique. Data were collected using an interviewer-administered questionnaire. Ever diagnosis of stroke was confirmed by medical doctors based on World Health Organization criteria and corroborated by documental evidence.


RESULTS
Of the total population (52.4% women; mean age, 44.2 years; SD, 16.6), the prevalence of stroke was 10.4 per 1000 (95% confidence interval, 6.3-14.5) with a 2:1 male:female ratio. Beyond the age of 65 years, the prevalence was higher by 6-fold among men and by 2-fold among women. Ninety two percent had developed hemiparesis, 58.3% had dysphasia, and 16.7% had loss of balance. Hypertension was the commonest risk factor (62.5%) followed by smoking (45.8%), excess alcohol (41.7%), diabetes mellitus (33.3%), and transient ischemic attack (29.2%); 79.2%, predominantly men, had ≥2 risk factors. A percentage of 58.3 had brain computed tomographic scans, of whom 85.7% had ischemic strokes. A percentage of 64.3 had to change or give up working because of stroke-related disability.


CONCLUSIONS
Age-adjusted stroke prevalence in urban Sri Lanka lies between high-income and low-/middle-income countries. The prevalence of stroke and its risk factors were higher among men.
From the Department of Clinical Medicine (T.C., S.G.), Department of Community Medicine (C.A.), and Faculty of Medicine (T.C., S.G., C.A.), University of Colombo, Colombo, Sri Lanka. thashichang@gmail.com.
Thashi
T
Chang
From the Department of Clinical Medicine (T.C., S.G.), Department of Community Medicine (C.A.), and Faculty of Medicine (T.C., S.G., C.A.), University of Colombo, Colombo, Sri Lanka.
Seneth
S
Gajasinghe
From the Department of Clinical Medicine (T.C., S.G.), Department of Community Medicine (C.A.), and Faculty of Medicine (T.C., S.G., C.A.), University of Colombo, Colombo, Sri Lanka.
Carukshi
C
Arambepola
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D001037:Aphasia / Q000209:etiology; D002545:Brain Ischemia / Q000150:complications / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D002546:Ischemic Attack, Transient / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology; D004856:Postural Balance; D015995:Prevalence; D012307:Risk Factors; D012678:Sensation Disorders / Q000209:etiology; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology*; D013188:Sri Lanka / Q000453:epidemiology; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014505:Urban Population; D055815:Young Adult
Sri Lanka; prevalence; risk factors; stroke