Background and Purpose-The importance of stroke in low-income regions such as sub-Saharan Africa has recently been emphasized. However, little is known about the burden of stroke in sub-Saharan Africa. We investigated the prevalence of stroke survivors in the Agincourt Health and Population Unit, a demographic surveillance site in the rural northeast of South Africa. Methods-Census workers asked household informants 2 screening questions for stroke during the annual census. If either question was answered positively, a clinician visited individuals aged Ն15 years to confirm the likely diagnosis of stroke. We performed a detailed assessment and defined stroke according to the World Health Organization criteria. Results-A total of 42 378 individuals were aged Ն15 years. There were 982 positive responses to the questionnaire, and we examined 724 individuals (74%). We identified 103 strokes (crude prevalence, 243/100 000). After adjustment for those we did not examine, the prevalence was 300/100 000 (95% CI, 250 to 357). Sixty-six percent of stroke survivors needed help with at least 1 activity of daily living (Segi age-standardized prevalence, 200/100 000). Conclusions-Stroke prevalence in rural South Africa is higher than previously documented in Africa but lower than in high-income countries. However, the prevalence of stroke survivors requiring help with at least 1 activity of daily living is already at high-income country levels. South Africa suffers from a huge burden of HIV/AIDS and diseases of poverty and violence and now faces the challenge of adapting its health systems to face the coming epidemic of vascular disease.

The data of the Australian Paediatric Cancer Registry on childhood cancer incidence in Australia for the 10-year period 1982-1 99 I are presented. The crude average annual incidence of cancer in children under the age of 15 years was 13.8 per IOO.000. The incidence of childhood cancer in Australia is rising. Significant increases were seen in acute non-lymphoblastic leukaemia, astrocytoma and melanoma. The age-standardised incidence of 14.4 per 100,000 is about 34% higher than in the UK. Most types of cancer had a higher incidence in Australia than in the UK, and the difference was significant for acute lymphoblastic leukaemia, astrocytoma and melanoma. Of particular interest is malignant melanoma, whose incidence in Australia is more than 5 times that in the UK, as a result of excessive UV exposure. Australia has a higher incidence of Ewing's turnour than osteosarcoma, nearly twice that of the UK. International comparative studies may help to elucidate the aetiology of these tumours. o 1996 Wiley-Liss, Inc.

The data of the Australian Paediatric Cancer Registry on childhood cancer incidence in Australia for the 10-year period 1982-1 99 I are presented. The crude average annual incidence of cancer in children under the age of 15 years was 13.8 per IOO.000. The incidence of childhood cancer in Australia is rising.Significant increases were seen in acute non-lymphoblastic leukaemia, astrocytoma and melanoma. The age-standardised incidence of 14.4 per 100,000 is about 34% higher than in the UK. Most types of cancer had a higher incidence in Australia than in the UK, and the difference was significant for acute lymphoblastic leukaemia, astrocytoma and melanoma. Of particular interest is malignant melanoma, whose incidence in Australia is more than 5 times that in the UK, as a result of excessive UV exposure. Australia has a higher incidence of Ewing's turnour than osteosarcoma, nearly twice that of the UK. International comparative studies may help to elucidate the aetiology of these tumours.o 1996 Wiley-Liss, Inc.