Study of Stroke Incidence in the Aseer Region, Southwestern Saudi Arabia

1. Introduction

Globally, the burden of stroke has increased rapidly over the past two decades [1]. Stroke has been estimated as the second leading cause of death and disability-adjusted life years [2,3]. Current epidemiological data indicate that 16.9 million people suffer a stroke each year, providing a global incidence of 258/100,000 persons/year and accounting for 11.8% of total deaths worldwide [3,4].

The Middle East region faces a variable burden of stroke. The incidence rate for all strokes ranged between 22.7 and 250 per 100,000 people per year in this region [5]. Because of the dramatic transformation of the social, economic, and environmental conditions over the past few decades in this region, the lifestyle has changed rapidly, which has caused a transition to a high burden of stroke.

Studies in Saudi Arabia have provided a hospital-based crude annual incidence rate of stroke of 15.1 per 100,000 persons in Jizan [6], 29.8 per 100,000 persons in the Eastern province [7], and 43.8 per 100,000 persons in Riyadh [8].

The Aseer region is located in the southwest of Saudi Arabia, covering an area of more than 80,000 km². The region extends from the high mountains of Sarawat (with an altitude of 3200 m above sea level) to the Red Sea and lies few kilometers from the northern border of neighboring Yemen. The region is bordering Jizan and is located to its northeast.

A national stroke registry is not available in Saudi Arabia. Recent data regarding the first-stroke incidence in Saudi Arabia in general and in the Aseer region in particular are scarce and even lacking. The aim of the present study was to study the first-time stroke incidence in the Aseer region, southwestern Saudi Arabia.

2. Materials and Methods

The last reported Aseer region population is 2,166,983 [9]. Health services delivery in the region is provided by a network of 242 primary health-care centers, 12 secondary-care hospitals, and one tertiary hospital (Aseer central hospital).

All newly admitted first-stroke cases in the study hospitals were diagnosed, and their records were revised by neurologists. The stroke case definition adopted in the present study described stroke as a focal neurological deficit due to cerebral infarction or hemorrhage, confirmed by computed tomography (CT) scan or Magnetic Resonance Imaging (MRI). This...