PREVALENCE AND RISK FACTORS OF ISCHEMIC STROKE IN RURAL SWAT, PAKISTAN: A HOSPITAL-BASED OBSERVATIONAL STUDY

Abstract

Background: Stroke is a significant burden in low- and middle-income countries, such as Pakistan, particularly in rural areas where access to healthcare is limited.

Purpose: The aim was to identify the prevalence, types, and risk factors associated with first-time stroke in Swat, Pakistan, to inform targeted prevention efforts.

Methods: This was a prospective observational study conducted between January and December 2024 at King Hospital (private) and Saidu Sharif Hospital (public) in Swat, Pakistan. A total of 150 patients with first-time strokes were enrolled and confirmed via MRI or CT scan. Information regarding demographics, stroke type, and risk factors was collected. Statistical analyses included descriptive statistics, chi-square tests, and logistic regressions, controlling for age and gender.

Findings: The most prevalent condition was ischemic stroke (IS) (81.3%, n=122), followed by intracerebral haemorrhage (ICH) (16.7%, n=25) and subarachnoid haemorrhage (SAH) (2.0%, n=3). The primary risk factors included hypertension (86.7%, n = 130), diabetes mellitus (64.7%, n = 97), and ischemic heart disease (42.7%, n = 64). IS was significantly associated with hypertension (OR = 2.5, 95% CI: 1.834, p < 0.001) and diabetes mellitus (OR = 1.8, 95% CI: 1.227, p = 0.005).

Conclusions: Community-based screening in rural Pakistan is essential due to the high prevalence of modifiable risk factors. Further population-based research is necessary to enhance generalisability and address unresolved issues in rural stroke epidemiology.