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. 2022 Feb;17(2):132-140.
doi: 10.1177/17474930211027834. Epub 2021 Jul 2.

Stroke in India: A systematic review of the incidence, prevalence, and case fatality

Stephanie P Jones  1 , Kamran Baqai  1 , Andrew Clegg  1 , Rachel Georgiou  1 , Cath Harris  1 , Emma-Joy Holland  1 , Yogeshwar Kalkonde  2 , Catherine E Lightbody  1 , Pallab K Maulik  3   4   5 , Padma Mv Srivastava  6 , Jeyaraj D Pandian  7 , Patel Kulsum  1 , P N Sylaja  8 , Caroline L Watkins  1 , Maree L Hackett  1   9
Affiliations

Stroke in India: A systematic review of the incidence, prevalence, and case fatality

Stephanie P Jones et al. Int J Stroke. 2022 Feb.

Abstract

Background: The burden of stroke is increasing in India; stroke is now the fourth leading cause of death and the fifth leading cause of disability. Previous research suggests that the incidence of stroke in India ranges between 105 and 152/100,000 people per year. However, there is a paucity of available data and a lack of uniform methods across published studies.

Aim: To identify high-quality prospective studies reporting the epidemiology of stroke in India.

Summary of review: A search strategy was modified from the Cochrane Stroke Strategy and adapted for a range of bibliographic databases from January 1997 to August 2020. From 7717 identified records, nine studies were selected for inclusion; three population-based registries, a further three population-based registries also using community-based ascertainment and three community-based door-to-door surveys. Studies represented the four cities of Mumbai, Trivandrum, Ludhiana, Kolkata, the state of Punjab, and 12 villages of Baruipur in the state of West Bengal. The total population denominator was 22,479,509 and 11,654 (mean 1294 SD 1710) people were identified with incident stroke. Crude incidence of stroke ranged from 108 to 172/100,000 people per year, crude prevalence from 26 to 757/100,000 people per year, and one-month case fatality rates from 18% to 42%.

Conclusions: Further high-quality evidence is needed across India to guide stroke policy and inform the development and organization of stroke services. Future researchers should consider the World Health Organization STEPwise approach to Surveillance framework, including longitudinal data collection, the inclusion of census population data, and a combination of hospital-registry and comprehensive community ascertainment strategies to ensure complete stroke identification.

Keywords: India; Stroke; case fatality; epidemiology; incidence; prevalence; systematic review.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA flow diagram of study selection.
Figure 2.
Figure 2.
Location of studies assessing the incidence, prevalence, and outcome of stroke in India.
See this image and copyright information in PMC

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