Abstract Details

Title Spatial Analysis of Cerebrovascular Disease Mortality Before and During the COVID-19 Pandemic in Peru, 2017-2022

Topic General Neurology

Presentation(s) P6 - Poster Session 6 (11:45 AM-12:45 PM)

Poster/Presentation
Number 11-021

Objective We analyzed the geographic distribution of stroke mortality in Peru before and during the COVID-19 pandemic.

Background Cerebrovascular disease (CVD) is a major global health issue, ranking second among causes of death and disability. The COVID-19 pandemic exacerbated healthcare challenges, particularly for non-communicable diseases like stroke. Peru, one of the hardest-hit countries, faced severe strain on its healthcare system due to COVID-19.

Design/Methods We conducted a secondary analysis of stroke-related deaths (2017-2022), sourced from the National Informatic System of Deaths, and population estimates from the National Registry of Identification and Civil Status. We estimated age- and sex-adjusted standardized mortality ratios (SMR) at department, province, and district levels. The spatial analysis utilized a Poisson-Lognormal model with spatially-autocorrelated random effects.

Results Stroke mortality varied annually across regions (p<0.001), mainly affecting the Northern and Southern jungle and highlands, with persistent high mortality throughout the study period. Between 2017-2019, there were 17,155 stroke-related deaths, increasing to 26,671 in 2020-2022. The highest SMR was observed in San Martin, peaking at 1.90 (95% UI [1.71-2.12]) in 2020. Pre-pandemic, provinces within San Martin, like Lamas and Picota, had SMRs above 2.00, while Marañon (SMR 2.19, 95% UI [1.44-3.36]) and Rioja (SMR 2.51, 95% UI [1.98-3.19]) showed high mortality during the pandemic. In Lima (coastal department), the SMR was 0.41 (95% UI [0.38-0.43]) in 2017, rising to 1.07 (95% UI [1.03-1.11]) by 2020. SMRs increased in most regions in 2020-2021, with a slight decrease in 2022.

Conclusions

The findings highlight persistent geographical disparities in stroke mortality in Peru, with the Northwest and Southern regions consistently showing higher SMRs than the national average. The pandemic amplified these inequities, emphasizing the need for equitable resource allocation and resilient healthcare infrastructure to mitigate future pandemic impacts on stroke outcomes. Improved coverage and accuracy of national registries are crucial for effective public health planning and interventions.

Authors/Disclosures
Arantxa N. Sanchez Boluarte, MD, MPH (UNIVERSIDAD PERUANA CAYETANO HEREDIA) PRESENTER	Dr. Sanchez Boluarte has received research support from NIH Fogarty International Center .
dayanne n. ataucury arones, MD	Dr. ataucury arones has nothing to disclose.
Cesar P. Carcamo, MD, PhD	Dr. Carcamo has nothing to disclose.
Joseph R. Zunt, MD (Harborview Medical Center)	The institution of Dr. Zunt has received research support from NIH. Dr. Zunt has received publishing royalties from a publication relating to health care.
Laura Dwyer-Lindgren, PhD	The institution of Dr. Dwyer-Lindgren has received research support from National Institutes of Health.

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