1. STEPS Stroke in the Carribbean Thomas Truelsen, PhD, DMSc, Consultant in Neurologi, Copenhagen, Denmark

2. Purpose The purpose of the STEPS-Stroke workshop is to... Make participants familiar with the STEPS Stroke manual; High-light potential problems and provide technical support on how to avoid them; Discussion experiences conducting stroke surveillance in the Carribean region; Develop the core structure for future stroke surveillance activities in the region based on STEPS Stroke

3. Rationale for Stroke Surveillance Stroke is a leading cause of death and a leading cause of acquried disability in adults; Stroke is a leading health expense; Stroke burden will increase with an increasing life expectancy and insufficient control of major RFs; Stroke is used as a marker for NCD occurrence; Stroke is clinically defined! Comparisons between and within populations are possible if using standard protocols

4. Test 1

5. Definitions (1-4 : 1-7)‏

6. The 3 potential steps* in STEPS Stroke (1-10:1-11) Patients at home Patients who die Hospital patients Population register to measure incidence, requires all 3 case finding steps + a well defined geographic population * According to ability to identify cases and relate them to a defined population + +

7. Planning and Preparing a Stroke Surveillance Study (Section 3 + 7b)‏ What is the goal? Identification of health facilities/GPs/other health authorities? Numerator? Core, expanded, optional? Translation of STEPS Stroke instrument?

9. Preparing the Stroke Surveillance Site (Section 4)‏ How many cases are expected per year? How many health facilities are included? How much staff and how trained? How/who enter data into what soft-ware? Where are the staff located? Sickness/pregnancy/other? Hot/Cold/Mixed pursuit? Test run!