Rise of ischaemic stroke incidence among Muslims during the Ramadan period: a 5-year observational study.

Introduction: Ischaemic stroke is a major health burden. The aim of this observational study was to compare the incidence of ischaemic stroke between Muslims and non-Muslims living in southern Thailand.

Methods: Patients with nonrecurrent computed tomography-proven ischaemic stroke admitted to Yala Regional Hospital during the Hijri years (AH) 1435-1439 were recruited for the study. Demographic, religious and risk factor data (hypertension, diabetes mellitus), smoking and atrial fibrillation) were collected. The study was divided into three periods using AH months as follows: baseline (months 1-4), pre-Ramadan (months 5-8) and Ramadan (months 9-12). Poisson regression was performed to explore the association between the time periods and rates of ischaemic stroke.

Results: Smoking was more common in Muslims than non-Muslims, with a higher incidence of 10.7 per 100,000 vs. 4.9 per 100,000 (P = 0.016). In relation to the three time periods, the incidence of ischaemic stroke was higher among Muslims than non-Muslims during Ramadan (13.5 vs. 5.4, P = 0.032), but not during the other time periods. For Muslims, the incidence rate ratio was higher during Ramadan (1.07; P = 0.049) than at baseline and pre-Ramadan (1.00 and 0.97, respectively; P = 0.576), whereas the ratios remained unchanged in the non-Muslim group.

Conclusion: There was a higher incidence of ischaemic stroke exclusively among Muslims during the Ramadan.