Socioeconomic status and stroke prevalence in Morocco: results from the Rabat-Casablanca study.

BACKGROUND: Stroke is a growing public health concern in low- and middle- income countries. Improved knowledge about the association between socioeconomic status and stroke in these countries would enable the development of effective stroke prevention and management strategies. This study presents the association between socioeconomic status and the prevalence of stroke in Morocco, a lower middle-income country. METHODS: Data on the prevalence of stroke and stroke-related risk factors were collected during a large population-based survey. The diagnosis of stroke in surviving patients was confirmed by neurologists while health, demographic, and socioeconomic characteristics of households were collected using structured questionnaires. We used Multiple Correspondence Analysis to develop a wealth index based on characteristics of the household dwelling as well as ownership of selected assets. We used logistic regressions controlling for multiple variables to assess the statistical association between socioeconomic status and stroke. FINDINGS: Our results showed a significant association between household socioeconomic status and the prevalence of stroke. This relationship was non-linear, with individuals from both the poorest (mainly rural) and richest (mainly urban) households having a lower prevalence of stroke as compared to individuals with medium wealth level. The latter belonged mainly to urban households with a lower socioeconomic status. When taking into account the urban population only, we observed that a third of poorest households experienced a significantly higher prevalence of stroke compared to the richest third (OR = 2.06; CI 95%: 1.09; 3.89). CONCLUSION: We conclude that individuals from the most deprived urban households bear a higher risk of stroke than the rest of the population in Morocco. This result can be explained to a certain extent by the higher presence of behavioral risk factors in this specific category of the population, which leads in turn to metabolic and physiological risk factors of stroke, such as obesity, diabetes, and hypertension.

The risk of flawed inference in evolutionary studies when detectability is less than one.

Addressing evolutionary questions in the wild remains a challenge. It is best done by monitoring organisms from birth to death, which is very difficult in part because individuals may or may not be resighted or recaptured. Although the issue of uncertain detection has long been acknowledged in ecology and conservation biology, in evolutionary studies of wild populations it is often assumed that detectability is perfect. We argue that this assumption may lead to flawed inference. We demonstrate that the form of natural selection acting on body mass of sociable weavers is altered and that the rate of senescence of roe deer is underestimated when not accounting for a value of detectability that is less than one. Because mark-recapture models provide an explicit way to integrate and reliably model the detection process, we strongly recommend their use to address questions in evolutionary biology.

Determination of lead in whole blood: comparison of the LeadCare blood lead testing system with Zeeman longitudinal electrothermal atomic absorption spectrometry.

This study compares the efficiency of blood lead level analysis by graphite furnace atomic absorption spectrometry (GFAAS) and the portable LeadCare Blood Lead Testing System (LCS). Recoveries of two added lead concentrations of 22 and 42 micrograms/dL ranged from 102.4 to 105.5% for LCS and from 96.3 to 97.2% for GFAAS. Measurement of a certified sample (Certified Danish Whole Blood) at a blood lead concentration of 26.2 micrograms/dL gave within- and between-run coefficients of variation which were both approximately 8% by LCS and 2% by GFAAS. Comparison of the tested method (LCS) versus GFAAS from analysis of 76 samples of blood lead collected from workers in different industrial sectors showed imperfect overall correlation (r = 0.95). The LCS is quite suitable for screening purposes, but requires the use of non-frozen blood collected less than 24 h before. Conservative threshold values should be applied when using the LCS for initial screening in the field.