TERRITORIAL AND SPATIAL CHARACTERISTICS OF CEREBROVASCULAR DISEASE MORBIDITY AND MORTALITY IN THE REPUBLIC OF MOLDOVA

Abstract

Introduction. Cerebrovascular diseases (CVDs) represent a major public health problem in the Republic of Moldova. Their effective management requires the analysis of territorial disparities and the impact of health crises.

The aim of the study was to assess the spatio-temporal dynamics of CVD incidence, prevalence, and mortality at district and regional levels during 2014–2024, with particular attention to changes observed during the COVID-19 pandemic and the post-pandemic period.

Materials and methods. A descriptive and observational epidemiological study was conducted based on official statistical data provided by the Ministry of Health. Indicators were calculated per 10,000 inhabitants (morbidity) and per 100,000 inhabitants (mortality) and were analyzed by regions (North, Center, South) and districts.

Results. During 2014–2024, the national prevalence doubled (from 247.5 to 471.2 per 10,000 population), while incidence reached a peak of 37.3 cases per 10,000 population in 2024. A marked mortality peak was observed in 2021 (226.7 deaths per 100,000 population), followed by an increase in recorded cases during the post-pandemic period. From a geospatial perspective, the Northern region was the most affected. Edineț district represented the highest morbidity area (incidence of 96.4 cases per 10,000 population), while Florești district recorded the highest mortality (350.5 deaths per 100,000 population). Criuleni district showed the lowest mortality (120.5 deaths per 100,000 population), with proximity to specialized services in the capital city representing a possible associated factor.

Conclusions. The results demonstrate a severe territorial fragmentation of CVD indicators, which may be influenced, among other factors, by population aging and differences in geographical access to emergency medical care, highlighting the need for decentralization of the stroke unit network.