Burden of Stroke: Indian Perspective
In recent years economic and demographic transitions in India have resulted in shift to lifestyle-related chronic diseases like stroke, ischemic heart disease (IHD), diabetes and cancer. In the year 2005, India accounted for more than 53% of all deaths and 44% of disability adjusted life years ( DALYs) lost from chronic diseases including stroke; without successful intervention, this is estimated to increase by 18% in the next 10 years. Furthermore, by 2016 an estimated US$ 84 billion of national income will be lost, in middle and low income countries, from chronic diseases alone. To reduce burden of disease in general, World Health Organization (WHO) has proposed a global goal, to reduce chronic disease mortality by 2% per year, over and above what will be achieved by routine intervention; and this is likely to avert 6.4 million deaths from stroke by 2015. However, there is paucity of standardized comparable data on stroke epidemiology to design sustainable primary or secondary prevention strategies. On account of scarce resources and high costs, modern stroke-care for timely treatment of acute stroke is beyond the reach of patients in India. Nonetheless, risk factors for stroke are mainly conventional and intervention to reduce exposure to raised blood pressure, diabetes mellitus, smoking, high cholesterol, and physical inactivity, and multidrug strategy will be cost-effective. Health education, low-salt intake, stopping tobacco use, and lifestyle changes may prove effective. Surveillance of cerebrovascular disease (CVD) risk factors and their determinants for intervention and prevention strategies need emphasis. Indian Council of Medical Research has initiated “risk factors surveillance” in populations. In addition, the Government of India has now launched National Rural Health Mission (NRHM) in support of the above objectives. To reduce the burden of disease in developing nations, an integrated approach for prevention (primary and secondary) of chronic diseases and stroke should receive high priority.
KeywordsVerbal Autopsy Stroke Risk Factor Disability Adjusted Life National Rural Health Mission NIHSS Score
List of Abbreviations:
- DALYs lost
disability adjusted life years lost
ischemic heart disease
human immunodeficiency virus/acquired immunodeficiency syndrome
Ministry of Health and Family welfare, Government of India
Oxford Health Alliance
global burden of disease
transient ischemic attack
global stroke initiative
World Health Organization
Indian Collaborative Acute Stroke Study
quality of life
tissue plasminogen activator
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