Deaths, disabilities from stroke rising as early symptoms ignored

Highlights: 

• Followed by road accidents and cardiovascular diseases, stroke is the third leading cause of death from non-communicable diseases in Bangladesh
• According to a recent study, stroke prevalence is 11.39 per thousand in Bangladesh
• The highest stroke prevalence was found in Mymensingh division and the lowest in Rajshahi division

Time is of the essence when it comes to the treatment of stroke patients and prompt treatment can reduce the risk of brain damage and prevent death.

Stroke, also known as a brain attack, occurs when something blocks the blood supply to a part of the brain or when a blood vessel in the brain bursts. It is one of the leading causes of brain damage, long-term disability and death among adults in Bangladesh. 

The first few hours are considered the 'golden hour' for a stroke patient. If the patient is admitted to hospital at the right time after suffering a stroke, a full recovery is possible with medication alone, according to neurologists.

Unfortunately, disability and death of stroke patients are increasing day by day because of the delay in understanding whether a stroke has occurred. Most of the time, stroke patients seek medical help when it is late, they said.

Dr Mohammad Shafiqul Islam, professor at the Department of Neurosurgery, Dhaka Medical College and Hospital (DMCH), said, "The first four hours after the stroke is very crucial. If treatment is begun during this time, most of the patients can recover completely."

"Even if treatment can start within six to 18 hours of the stroke, it is possible to save many patients from paralysis and death," he said.

Shafiqul Islam said patients are usually late in knowing if they are suffering from a stroke. Most stroke patients first go to the National Institute of Cardiovascular Diseases thinking it is a heart attack. 

"By the time they realise it was a stroke and arrive at DMCH or Bangabandhu Sheikh Mujib Medical University (BSMMU), it is already too late for treatment. Sometimes the lack of readiness on the part of the hospitals also leads to delayed treatment," said the neurosurgeon.

From the hospital management to doctors, anaesthesiologists and relatives of the patients – all should be aware so that patients can get medical services quickly, Dr Shafiqul Islam added.

According to a study, "Prevalence and risk factors of stroke in Bangladesh: A nationwide population-based survey", stroke prevalence is 11.39 per thousand in Bangladesh. 

The highest stroke prevalence was found in the country's Mymensingh division and the lowest was found in Rajshahi division. The prevalence is higher in rural areas than in urban regions, the study found.

Stroke prevalence was found to be 4.60 per thousand in the age group below 40 years. The prevalence was much higher in the elderly and male population.  

The study, conducted on 25,287 people in eight administrative divisions and 64 districts, was published in ScienceDirect journal in September 2022.

After road accidents and cardiovascular diseases, stroke is the third leading cause of death from non-communicable diseases in Bangladesh.

Stroke killed 134,166 people in the country in 2019, with the death rate being 82.3 per 100,000 people, according to the World Health Organisation's Global Health Estimates (GHE).

Stroke killed 130,655 people in 2010. The death toll from stroke increased by 13.7% in 2019, compared to 2015, as GHE data show.

Dr Mohammad Hossain, professor at the Department of Neurosurgery and Dean of the Faculty of Surgery at BSMMU, said difficulty in speaking, dizziness, loss of balance, facial palsy and sudden fainting are symptoms of a stroke.

"Stroke cannot be eradicated but can be controlled. If symptoms of stroke appear, the patient should be taken to the doctor immediately. Any MBBS doctor referring a patient to a medical college hospital with primary management of stroke will reduce mortality and disability," he said, adding that in Bangladesh, stroke patients have very few opportunities of making use of the golden hour for treatment. 

Maintaining a healthy lifestyle, controlling blood pressure, not smoking, being physically active and a healthy diet characterised by adequate fruit and vegetable intake, and reduced intake of salt and trans-fats can prevent stroke, Professor Hossain added.

29 October is World Stroke day. This year the theme of World Stroke Day is "#Precioustime", promoted by World Stroke Organisation (WSO) to stress awareness of World Stroke Day and support the campaign to pace up the previous year's 2021 campaign, "Minutes Can Save Lives".