Exploration of Epidemiological Characteristics for the Occurrence of Stroke in One Chronic Demonstration Area of Zhejiang Province in China: A Retrospective Study from 2009-2015
Background: Fenghua County, located on the eastern coast of Zhejiang Province, showed a higher stroke incidence than other counties of Ningbo Municipality while the potential epidemiology pattern was not explored.
Methods: The study data of first-ever stroke cases were collected from the Internet-based Comprehensive Chronic Disease Surveillance System (ICDSS) in Zhejiang Province. Spatio-temporal analysis and time series model were explored and constructed to identify the epidemiological characteristics in local.
Results: A total of 10215 first-ever strokes were reported in Fenghua County from 2009 to 2015, including 8292 ischemic strokes (81.18%), 1839 hemorrhagic strokes (18.00%), and 84 unclassifiable strokes (0.82%). According to occupational distribution, peasants had the highest proportion (82.59%). Also, ischemic stroke was the main stroke subtype with a proportion of 81.18%. Space-time scan analysis, among 26 residential communities in Fenghua County from the period of 2009-2015, presented that only one most likely cluster was identified in 2009 with the relative risk (RR) value of 1.15. Besides, the ARIMA (0,1,2) model was determined as the optimal one to predict the trend of stroke.
Conclusion: Under the trend of an aging population, the stroke incidence in Fenghua County was increased with the ischemic stroke as the main subtype. Peasant groups and persons in middle age and above were the targeted objects for the control and prevention of stroke. Besides, specific interventions, like hypertension health management and health education, should be strengthened to reduce the incidence of stroke effectively in the future.
2. GBD 2015 DALYs and HALE Collabora-tors. (2016). Global, regional, and nation-al disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a sys-tematic analysis for the Global Burden of Disease Study 2015. Lancet, 388(10053):1603-1658.
3. Writing Group Members, Mozaffarian D, Benjamin EJ, et al (2016). Heart disease and stroke statistics-2016 update: a report from the American Heart Association. Circulation, 133 (4): e38-360.
4. Wang W, Jiang B, Sun H, et al (2017). Preva-lence, incidence, and mortality of stroke in China: results from a nationwide population-based survey of 480687 adults. Circulation, 135 (8): 759-71.
5. National Center for Cardiovascular Disease (2017). Report on Cardiovascular Disease in China 2016. Encyclopedia of China Publish-ing House: Beijing, China.
6. Feigin VL, Krishnamurthi RV, Parmar P, et al (2015). Update on the global burden of ischemic and hemorrhagic stroke in 1990-2013: the GBD 2013 study. Neuroep-idemiology, 45 (3): 161-76.
7. Feigin VL, Norrving B George MG, et al (2016). Prevention of stroke: a strategic global imperative. Nat Rev Neurol, 12 (9): 501-12.
8. Liu M, Wu B, Wang WZ, et al (2007). Stroke in China: epidemiology, preven-tion, and management strategies. Lancet Neurol, 6 (5): 456-64.
9. Gorelick PB (1994). Stroke prevention. An opportunity for efficient utilization of health care resources during the coming decade. Stroke, 25 (1): 220-4.
10. Li R, Cheng S, Luo C, et al (2017). Epide-miological characteristics and spatial-temporal clusters of mumps in Shandong Province, China, 2005-2014. Sci Rep,7: 46328.
11. Hamer D, Lichtveld M (2015). Spatial distri-bution of epidemiological cases of den-gue fever in Suriname, 2001-2012. West Indian Med J, 64 (4): 344-50.
12. Liu K, Cai J, Wang S, et al (2016). Identifica-tion of distribution characteristics and ep-idemic trends of hepatitis E in Zhejiang Province, China from 2007 to 2012. Sci Rep, 6: 25407.
13. Tang F, Cheng Y2, Bao C, et al (2014). Spa-tio-temporal trends and risk factors for Shigella from 2001 to 2011 in Jiangsu Province, People's Republic of China. PLoS One, 9 (1): e83487.
14. Agarwal S, Nguyen DT1, Teeter LD, et al(2017). Spatial-temporal distribution of genotyped tuberculosis cases in a county with active transmission. BMC Infect Dis, 17 : 378.
15. Lin Y, Chen M, Chen G, et al (2015). Appli-cation of an autoregressive integrated moving average model for predicting in-jury mortality in Xiamen, China. BMJ Open, 5 : e008491.
16. Gong W, Wei X2, Liang Y, et al (2016). Ur-ban and rural differences of acute cardio-vascular disease events: a study from the population-based real-time surveillance system in Zhejiang, China in 2012. PLoS One, 11 (11): e0165647.
17. WHO (1999). WHO MONICA manual (In-ternet), Part IV: event registration; section 2: stroke event registration data compo-nent. World Health Organization. http://www.thl.fi/publications/monica/strokeqa/strokeqa.htm
18. Hua Gu, Wenjie Fan, Kui Liu, et al (2017). Spatio-temporal variations of typhoid and paratyphoid fevers in Zhejiang Prov-ince, China from 2005 to 2015. Sci Rep, 7: 5780.
19. Zeng Q, Li D, Huang G, et al (2016). Time series analysis of temporal trends in the pertussis incidence in Mainland China from 2005 to 2016. Sci Rep, 6 :32367.
20. Ansari H, Mansournia MA, Izadi S, et al (2015). Predicting CCHF incidence and its related factors using time-series analy-sis in the southeast of Iran: comparison of SARIMA and Markov switching mod-els. Epidemiol Infect, 143 (4): 839-50.
21. Liu L, Luan RS, Yin F, et al (2016). Predict-ing the incidence of hand, foot and mouth disease in Sichuan province, Chi-na using the ARIMA model. Epidemiol In-fect, 144 (1): 144–51.
22. Sun X, Wang Y, Zhang N, et al (2014). Inci-dence and trends of stroke and its sub-types in Changsha, China from 2005 to 2011. J Clin Neurosci, 21 (3): 436-40.
23. Jiang B, Wang WZ, Chen H, et al (2006). Incidence and trends of stroke and its subtypes in China: results from three large cities. Stroke, 37 (1): 63-8.
24. Zhao D, Liu J, Wang W, et al (2008). Epi-demiological transition of stroke in Chi-na: twenty-one-year observational study from the Sino-MONICA-Beijing Project. Stroke , 39 (6): 1668-74.
25. Kleindorfer D, Broderick J, Khoury J, et al (2006). The unchanging incidence and case-fatality of stroke in the 1990s: a population-based study. Stroke, 37 (10): 2473-8.
26. Benatru I, Rouaud O, Durier J, et al (2006). Stable stroke incidence rates but im-proved case-fatality in Dijon, France, from 1985 to 2004. Stroke, 37 (7): 1674-9.
27. Sivenius J, Tuomilehto J, Immonen-Räihä P, et al (2004). Continuous 15-year decrease in incidence and mortality of stroke in Finland: the FINSTROKE study. Stroke, 35 (2): 420-5.
28. Boden-Albala B, Elkind MSV, White H, et al (2009). Dietary total fat intake and is-chemic stroke risk: the Northern Man-hattan Study. Neuroepidemiology, 32 (4): 296-301.
29. Boden-Albala B, Sacco RL, Lee HS, et al (2008). Metabolic syndrome and ischemic stroke risk: Northern Manhattan Study. Stroke, 39 (1): 30-5.
30. Poorthuis MHF, Algra AM, Algra A, et al (2017). Female-and male-specific risk fac-tors for stroke: a systematic review and meta-analysis. JAMA Neurol, 74 (1): 75-81.
31. Barker-Collo S, Bennett DA, Krishnamurthi RV, et al (2015). Sex differences in stroke incidence, prevalence, mortality and disa-bility-adjusted life years:results from the Global Burden of Disease Study 2013. Neuroepidemiology, 45 (3): 203-14.
32. Song W, Wu J (2014). Statistical analysis of the relationship between stroke onset and some aspects like age, occupation, time and climate. Chinese Journal of Health Statis-tics, 31 (4): 648-50.
33. Pan D, Zou C (2009). Analysis of risk fac-tors of stroke in Lucheng District, Wen-zhou. Prevention and Treatment of Cardio Cer-ebral Vascular Disease, 9 (4): 291-92.
34. Ye H, Zhang S (2006). Study on related risk factors of stroke in Wuhan. Journal of Chi-nese Physician, 18 (10): 1436-37.
35. Wang W, Jian B, Wu SP, et al (2007). Change in stroke incidence from a population-based intervention trial in three urban communities in China. Neuroepidemiology, 28 (3): 155-61.
36. Wu XG, Gu DF, Wu YF, et al (2003). An evaluation on effectiveness of worksite-based intervention for cardiovascular dis-ease during 1974-1998 in capital iron and steel company of Beijing. Zhonghua Yu Fang Yi Xue Za Zhi, 37 (2): 93-7.
37. Gan WQ, Gu DF, Xu XS, et al (2001). The effect of Beijing Fangshan Cardiovascular Prevention Program on the incidence and mortality of stroke. Zhongguo Yi Xue Ke Xue Yuan Xue Bao, 23 (5): 428-31.
|Issue||Vol 49 No 3 (2020)|
|Stroke Epidemiology Spatio-temporal analysis Time series analysis|
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