Urgent appeal to improve global stroke care

Global stroke care begs urgent attention, particularly in low-middle income countries. Every year, about 15 million face a stroke event in the world. Of them, about 5 million die while another 5 million become disable permanently. Almost 70 percent of stroke events occur in low-middle income countries. Alarmingly, while the new cases per 100,000 declined by half in high-income countries during the past decade, it doubled in low-middle income countries (Johnson et al., 2016).

Globally, 70 percent of stroke events and deaths occur in low-middle income countries

The Lancet, 2014

More importantly, stroke occurs mostly at peak of one’s life.

Although vast improvements have occurred in stroke care in the world during the past decade,, these advances have not reached to low-middle income countries.

More specifically the advances are the establishment of dedicated stroke units, use of clot-busting medication, and availability of clot removal technology as reported by experts.

However, according to Walter Johnson and his colleagues, significant differences between high-income and low-middle income countries exist; that more stroke due to bleeding in low-middle income countries than high-income countries (34 percent versus 9 percent); that more survivors in low-middle income countries die within 3 years than high-income countries (84 percent versus 16 percent).

Surely the quality of care should also be remarkably different. For example, the absence of CT scan facility to differentiate strokes due to bleeding from a blood clot affect the intervention strategy.

A well coordinated global action is necessary as highlighted by the WHO experts.

Author: Prasantha De Silva

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