Rise in stroke cases: experts call for integrated approach to treatment, rehabilitation

Noting that the incidence of stroke in India has increased almost 100 per cent in the past few decades, neurologists and public health experts on Thursday called for an integrated and comprehensive approach to treatment and rehabilitation.

At the first Stroke Summit, organised by thinktank Integrated Health and Wellbeing (IHW) Council and endorsed by World Stroke Organization, experts said stroke incidence in India is higher (194-215 per 100,000 population) in rural areas when compared to the national average (119-145 per 100,000 population).

Noting that stroke is the leading cause of death in the north-eastern states, surpassing cardiac problems and tuberculosis, MV Padma Srivastava, chief of Neurosciences Centre at AIIMS, said it has become the 5th leading cause of death in 2016 from 12th a decade ago and claims 119-145 lives in every 100,000 population, which is almost a 100 per cent increase.

"Our stroke burden is enormous but we need more of small, India-centric solutions. Every year, 1.8 million people suffer stroke in India, but we have only about 2,000 neurologists. We need to understand and acknowledge that time is brain' and plug the gaps such as lack of awareness, delay in arrival, and lack of centres offering thrombolysis.

"Thrombolysis is a game-changer in the stroke management sector and mobile stroke units, like those in the northeast, can offer relief. We also need to look into amalgamating different approaches such as Ayurveda and homeopathy to bring the patient back into disease-free mode," Srivastava said.

According to the Global Burden of Disease study of 2013, 25.7 million people survived stroke, 6.5 million died, and 10.3 million new strokes were recorded. It also noted that the low-and middle-income countries, of which India is a part, have witnessed more than 100 per cent increase in incidence of stroke, whereas the developed countries have witnessed a drop of 42 per cent.

Highlighting that the average mortality of stroke in rural India is more than the country average, Jeyaraj Pandian, vice-president of World Stroke Organization, said, "Our study in rural India showed that mortality is higher than the Indian average. In Gadchiroli, Maharashtra, it was found to be 194 in every 100,000 population while rural areas around Ludhiana, Punjab, the mortality is 210 in every 100,000 population.

"The gaps in India include pre-hospital care, stroke services, thrombolysis and rehabilitation of stroke patients that we need to address to bolster our continuum of care."