10.25384/SAGE.C.6318047
Bonnie Yin Ka Lam
Bonnie Yin Ka
Lam
Yuan Cai
Yuan
Cai
Rufus Akinyemi
Rufus
Akinyemi
Geert Jan Biessels
Geert Jan
Biessels
Hilde van den Brink
Hilde
van den Brink
Christopher Chen
Christopher
Chen
Chin Wai Cheung
Chin Wai
Cheung
King Ngai Chow
King Ngai
Chow
Henry Kwun Hang Chung
Henry Kwun Hang
Chung
Marco Duering
Marco
Duering
Siu Ting Fu
Siu Ting
Fu
Deborah Gustafson
Deborah
Gustafson
Saima Hilal
Saima
Hilal
Vincent Ming Ho Hui
Vincent Ming Ho
Hui
Rajesh Kalaria
Rajesh
Kalaria
SangYun Kim
SangYun
Kim
Maggie Li Man Lam
Maggie Li Man
Lam
Frank Erik de Leeuw
Frank Erik
de Leeuw
Ami Sin Man Li
Ami Sin Man
Li
Hugh Stephen Markus
Hugh Stephen
Markus
Anna Marseglia
Anna
Marseglia
Huijing Zheng
Huijing
Zheng
John O’Brien
John
O’Brien
Leonardo Pantoni
Leonardo
Pantoni
Perminder Singh Sachdev
Perminder Singh
Sachdev
Eric E Smith
Eric E
Smith
Joanna Wardlaw
Joanna
Wardlaw
Vincent Chung Tong Mok
Vincent Chung Tong
Mok
The global burden of cerebral small vessel disease in low- and middle-income countries: A systematic review and meta-analysis
<div>Background:<p>Cerebral small vessel disease (cSVD) is a major cause of stroke and dementia. Previous studies on the prevalence of cSVD are mostly based on single geographically defined cohorts in high-income countries. Studies investigating the prevalence of cSVD in low- and middle-income countries (LMICs) are expanding but have not been systematically assessed.</p>Aim:<p>This study aims to systematically review the prevalence of cSVD in LMICs.</p>Results:<p>Articles were searched from the Ovid MEDLINE and EMBASE databases from 1 January 2000 to 31 March 2022, without language restrictions. Title/abstract screening, full-text review, and data extraction were performed by two to seven independent reviewers. The prevalence of cSVD and study sample size were extracted by pre-defined world regions and health status. The Risk of Bias for Non-randomized Studies tool was used. The protocol was registered on PROSPERO (CRD42022311133). A meta-analysis of proportion was performed to assess the prevalence of different magnetic resonance imaging markers of cSVD, and a meta-regression was performed to investigate associations between cSVD prevalence and type of study, age, and male: female ratio. Of 2743 studies identified, 42 studies spanning 12 global regions were included in the systematic review. Most of the identified studies were from China (n = 23). The median prevalence of moderate-to-severe white matter hyperintensities (WMHs) was 20.5%, 40.5%, and 58.4% in the community, stroke, and dementia groups, respectively. The median prevalence of lacunes was 0.8% and 33.5% in the community and stroke groups. The median prevalence of cerebral microbleeds (CMBs) was 10.7% and 22.4% in the community and stroke groups. The median prevalence of moderate-to-severe perivascular spaces was 25.0% in the community. Meta-regression analyses showed that the weighted median age (51.4 ± 0.0 years old; range: 36.3–80.2) was a significant predictor of the prevalence of moderate-to-severe WMH and lacunes, while the type of study was a significant predictor of the prevalence of CMB. The heterogeneity of studies was high (>95%). Male participants were overrepresented.</p>Conclusions:<p>This systematic review and meta-analysis provide data on cSVD prevalence in LMICs and demonstrated the high prevalence of the condition. cSVD research in LMICs is being published at an increasing rate, especially between 2010 and 2022. More data are particularly needed from Sub-Saharan Africa and Central Europe, Eastern Europe, and Central Asia.</p></div>
Cardiology
Medicine
Neurology and Neuromuscular Diseases
SAGE Journals
2022
2022-11-26
2022-11-26
Collection
CC BY 4.0