Incidence of Stroke in Indigenous Populations of Countries With a Very High Human Development Index: A Systematic Review.
Date
2024
Authors
Balabanski, A.H.
Dos Santos, A.
Woods, J.A.
Mutimer, C.A.
Thrift, A.G.
Kleinig, T.J.
Suchy-Dicey, A.M.
Siri, S.R.A.
Boden-Albala, B.
Krishnamurthi, R.V.
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Journal article
Citation
Neurology, 2024; 102(5):e209138-e209138
Statement of Responsibility
Anna H. Balabanski ... Timothy J. Kleinig ... Alex Brown ... et al.
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Abstract
Background and Objectives: Cardiovascular disease contributes significantly to disease burden among many Indigenous populations. However, data on stroke incidence in Indigenous populations are sparse. We aimed to investigate what is known of stroke incidence in Indigenous populations of countries with a very high Human Development Index (HDI), locating the research inthe broader context of Indigenous health. Methods: We identified population-based stroke incidence studies published between 1990 and 2022 among Indigenous adult populations of developed countries using PubMed, Embase, and Global Health databases, without language restriction. We excluded non–peer-reviewed sources, studies with fewer than 10 Indigenous people, or not covering a 35- to 64-year minimum age range. Two reviewers independently screened titles, abstracts, and full-text articles and extracted data. We assessed quality using “gold standard” criteria for population-based stroke incidence studies, the Newcastle-Ottawa Scale for risk of bias, and CONSIDER criteria for reporting of Indigenous health research. An Indigenous Advisory Board provided oversight for the study. Results: From 13,041 publications screened, 24 studies (19 full-text articles, 5 abstracts) from 7 countries met the inclusion criteria. Age-standardized stroke incidence rate ratios were greater in Aboriginal and Torres Strait Islander Australians (1.7–3.2), American Indians (1.2), S´ami of Sweden/Norway (1.08–2.14), and Singaporean Malay (1.7–1.9), compared with respective non-Indigenous populations. Studies had substantial heterogeneity in design and risk of bias. Attack rates, male-female rate ratios, and time trends are reported where available. Few investigators reported Indigenous stakeholder involvement, with few studies meeting any of the CONSIDER criteria for research among Indigenous populations.
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© 2024 American Academy of Neurology.