Stroke research is grossly underfunded even in developed countries (21 ). One of the major problems of stroke epidemiology is the lack of good-quality epidemiological studies in developing countries, where most strokes occur and resources are limited. To address the problem of accurate and comparable data in these countries, an approach to increase the quality of the data collected for stroke surveillance has recently been proposed by WHO. This flexible and sustainable system includes three steps: standard data acquisition (recording of hospital admission rates for stroke), expanded population coverage (calculation of mortality rates by the use of death certificates or verbal autopsy), and comprehensive population-based studies (reports of nonfatal events to calculate incidence and case-fatality). These steps could provide vital basic epidemiological estimates of the burden of stroke in many countries around the world (20).

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