Stroke epidemiology in the developing world

The Lancet
Feigin VL
One of the major problems of stroke epidemiology is the lack of good-quality epidemiological studies in developing countries. Despite over two-thirds of stroke deaths worldwide occurring in developing countries, there have been few population-based incidence studies of stroke in these populations, and none from Latin America.

A study of stroke incidence and outcomes by Pablo Lavados and colleagues in Iquique, Chile (the PISCIS Project), in today's Lancet helps to fill this gap in our knowledge. This is the first study of population-based incidence of stroke in Latin America that meets not only the standard1 but also the most rigorous criteria for an ideal study of stroke incidence.2 Completeness of case ascertainment with multiple overlapping sources of information in a relatively large study area, a high level of early verification of stroke subtypes by CT (91%), and comprehensiveness of the report are impressive and leave no doubts about the methodological soundness of the study. The key findings are that stroke outcomes and incidence rates in the predominantly Hispanic-Mestizo population of Iquique are similar to incidence rates in other populations, but the proportion of intracerebral haemorrhage was somewhat higher.