Incidence and Prevalence of Stroke and its Risk Factors in the Philippines: A Systematic Review

Background. Various epidemiologic studies reported different stroke incidence and prevalence rates in the Philippines. Thus, there is a need to synthesize existing information on these indicators to depict more accurate evidence on the burden on stroke in the country. Objective. The objective of this systematic review is to provide evidence on the incidence and prevalence of stroke in the Philippines, as well as its associated risk factors. Methods. PubMed and HERDIN were searched for available full-text Philippine epidemiologic studies on stroke incidence and prevalence, whether population or hospital-based, and its associated risk factors. We used three tools for risk of bias assessment, namely, the Newcastle Ottawa Scale for cohort studies, the Quality assessment checklist of Hoy et al. for cross-sectional prevalence studies, and the AXIS tool for general cross-sectional studies. Results. A total of 14 studies were included in this review. Based on these studies, the national stroke incidence rate ranged from 3.95% to 5.61%, while the national stroke prevalence rate ranged from 0.486% to 6.0%. Hypertension remains the commonly reported risk factor of stroke alongside diabetes, smoking, and high cholesterol level. Conclusions. Despite limitations, we were able to perform a complete assessment of the risk of bias in included studies which provide information on the studies with reliable information. Based on this systematic review, there is variability on data and limited studies on the national epidemiology of stroke in the Philippines. It is recommended that the national government consider establishing a system such as a national registry for better data collection and analysis.