ERMANCIA: Epidemiology of stroke in Martinique, French West Indies Part I:Methodology, incidence, and 30-day case fatality rate

Background and Purpose-The ERMANCIA (Etude Realisee en Martinique et Centre e sur l'Incidence de Accidents vasculaires cerebraux) study was designed to provide the first comparable epidemiological data on stroke in a black Car ibbean population. Methods-ERMANCIA was a prospective community-based study performed in Marti nique (French West Indies) from June 1, 1998, to May 31, 1999. The black at -risk population was approximately 360 000. Multiple sources were used to i dentify hospitalized and nonhospitalized patients with first-ever stroke. Results-Five hundred eighty patients (285 men and 295 women; mean SID age, 71.2 +/- 14 years) suffered from a first-ever in a lifetime stroke, yieldin g a crude annual incidence of 164/100 000 per year (95% CI, 151 to 177). Th e rates adjusted by age and sex to the French population (1999 census) and to the European population were 202 (95% CI, 185 to 218) and 151 (95% CI, 1 39 to 164), respectively. Thirty-eight patients (6.5%) were not hospitalize d during the acute phase of the stroke; 92.8% had CT scan. Pathological typ es of strokes were infarction (79.8%, including 23% of lacunar strokes), in tracerebral hemorrhage (14.3%), subarachnoid hemorrhage (3.4%), and undeter mined (2.4%). The main risk factors for stroke were hypertension (69.1%) an d diabetes (29.5%). The 30-day case fatality rate was 19.3% (15.8% for cere bral infarction and 37.3% for intracerebral hemorrhage). Conclusions-In Martinique, the ERMANCIA population-based study showed a hig h stroke incidence and a high prevalence of hypertension and diabetes in th e stroke population compared with those observed in continental France. Epi demiological data on stroke in African Caribbeans from Martinique are compa rable to those reported in blacks from the United States and United Kingdom .