---
title: "Access Blocked: Unable to Retrieve BMJ Open Stroke Study on Tea‑Tribe Communities in Cachar, Assam"
id: "bmj-open-2-burden-unmet-healthcare-and-associated-disabilities-among-people-with-prevalent"
canonical_url: "https://medichelpline.com/clinical-feed/bmj-open-2-burden-unmet-healthcare-and-associated-disabilities-among-people-with-prevalent"
content_type: "clinical_feed_article"
specialty: "Neurology"
source_name: "BMJ Open"
source_url: "http://bmjopen.bmj.com/cgi/content/short/16/8/e114655?rss=1"
published_at: "2026-08-24T09:54:21.000Z"
evidence_level: "Journal Feed"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Access Blocked: Unable to Retrieve BMJ Open Stroke Study on Tea‑Tribe Communities in Cachar, Assam
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/bmj-open-2-burden-unmet-healthcare-and-associated-disabilities-among-people-with-prevalent
- **Specialty:** [Neurology](https://medichelpline.com/clinical-feed/neurology.md)
- **Primary Source:** BMJ Open
- **Source URL:** [Original Journal Publication](http://bmjopen.bmj.com/cgi/content/short/16/8/e114655?rss=1)
- **Published At:** 2026-08-24T09:54:21.000Z
- **Evidence Rating:** Journal Feed
## Executive GIST (TL;DR)
- The BMJ Open page for the article on **stroke** burden and unmet healthcare needs in tea‑tribe communities of Cachar district, Assam could not be accessed; the source returned a website block error from Cloudflare. - The Cloudflare block page indicated the request triggered a security rule; it provided a Cloudflare Ray ID and suggested contacting the site owner to resolve the block. - No content from the original research article (methods, results, sample size, prevalence, disability measures, or conclusions) was available on the blocked page; therefore, study specifics are not reported in the accessible source. - Because the source is the sole authority provided, any clinical, epidemiologic, or statistical details about stroke burden, unmet healthcare, or associated disabilities in the tea‑tribe population cannot be summarized or inferred. - The accessible page recommended contacting the site owner and provided the Cloudflare Ray ID; it also displayed a prompt to enable cookies as part of the security message. - Practical steps to obtain the full article were not included in the source content but can include contacting BMJ Open support, accessing the article through institutional subscriptions, requesting the corresponding author, or searching alternative repositories — these are suggested remediation actions, not data from the blocked page.
## Clinical Analysis & Structured Key Points
Background Tea-tribe communities in Assam face a substantial and under-recognised burden of stroke, shaped by socioeconomic marginalisation, limited access to formal healthcare and distinct cultural practices. Objective We estimated the prevalence of physician-diagnosed stroke, described associated functional and psychological disabilities, characterised gaps in diagnosis and care, and developed a logistic regression-based classification score for prevalent stroke among tea-tribe adults in Cachar district, Assam, Northeast India. Methods We conducted a community-based cross-sectional door-to-door survey (July 2024 - August 2025) across five tea estates among permanent tea-tribe residents aged ≥18 years. Trained community health workers collected data on sociodemographics, vascular risk factors, healthcare utilisation and poststroke functional and psychological outcomes using a structured questionnaire, the Modified Rankin Scale and a symptom inventory. Stroke was identified through community symptom screening and confirmed by teleconsultation with a senior neurologist, supported by neuroimaging where available. A multivariable logistic regression model with stepwise selection identified factors associated with prevalent stroke and regression coefficients were converted into an additive point-based classification score. Internal validation used 1000 bootstrap samples and a 70:30 train - test split. The model performance was assessed using the area under the receiver operating characteristic curve and Brier score. Results Among 3818 participants, 164 had a history of stroke (prevalence 4.3%), with a higher prevalence in older adults, men, unemployed or semiskilled or skilled workers and households below the poverty line. Hypertension was the strongest risk factor and its combination with daily tea containing added salt was associated with markedly higher odds of stroke. Alcohol consumption, smoking and previous heart disease were also associated with stroke. Stroke survivors had high functional and psychological burdens and fewer than half reached a health facility within 4.5 hours or underwent CT/MRI. The final model showed good discrimination (area under the curve 0.84) and calibration (Brier score 0.037). The derived classification score (0 - 19 points) identified a highly associated group (scores >13) with a stroke prevalence of 14.5%. Conclusions The tea-tribe community in Assam faces a high stroke burden, substantial disability and major gaps in timely diagnosis and care. A simple, internally validated classification score based on demographic, socioeconomic and vascular factors may help target community screening and prevention but requires external validation and cautious interpretation given the cross-sectional design and self-reported exposures.
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