Estimation of Mortality and Morbidity due to Strokes in India

Abstract

In order to control the stroke problem, its magnitude should be assessed. India is ranked among the countries where the information on stroke is minimal. We decided to review the information available in order to estimate the mortality and morbidity due to stroke in India. Information was collected through electronic search, hand search and contact with experts. Each article was reviewed for relevance and epidemiological rigor. The demographic data were as derived from published government figures. The prevalence from individual studies was pooled and weighted based on sample size. Analysis was done separately for males and females at 10-year intervals (20 years onwards). A total of 7 studies was located, but 2 were discarded. All were done in rural areas except 2 which also included urban areas. The prevalence was estimated as 203 per 100,000 population above 20 years amounting to a total of about 1 million cases. The male to female ratio was 1.7. Around 12% of all strokes occurred in population below 40 years. The estimation of stroke mortality was seriously limited by the method of classification of cause of death in the country. The best estimate derived was 102,000 deaths; which represented 1.2% of total deaths in the country. There is need to initiate steps to collect data on morbidity and mortality due to stroke in the country as a first step towards control measures.

Blood pressure, diabetes, and increased dietary salt associated with stroke – results from a community-based study in Pakistan

“…This suggests a fairly high burden of premature strokes in Pakistan, which is consistent with previous reports of early onset of complications of hypertension and cardiovascular disease in the South Asian population. 6 The finding of an equal proportion of stroke in men and women is consistent with our previous reports indicating an equally high, if not a higher burden of risk factors of CVD in women, including diabetes, than in men in Pakistan. 7 Efforts are needed for education of GPs for appropriate management and prevention of these chronic diseases.…”

“…Evidence from India, while scanty, suggests a high burden of mortality due to stroke, particularly in the younger age group. 6 We have previously reported a higher prevalence of hypertension in Pashtuns, one of five major ethnic subgroups in Pakistan (others are Muhajirs, Punjabis, Sindhis, and Baluchis). We, therefore, undertook this study to estimate the prevalence and associates of stroke in the adult Pashtun population in Karachi, Pakistan.…”

Stroke survivors in low- and middle-income countries: A meta-analysis of prevalence and secular trends

“…This may have been due to the high fatality rates from stroke owing to less investment in health care, increased poverty and co-morbidities like HIV/AIDS and Tuberculosis [26][27][28]. The early stage of epidemiological transition characterised by hypertensive heart disease and a huge proportion of haemorrhagic stroke disease are now occurring in these countries [29].…”

Stroke

“…It has been estimated that stroke represented 1.2% of the total deaths in the country when all ages were included. 40 The proportion of stroke death increased with age, and in the oldest group (Ͼ70 years of age), stroke contributed to 2.4% of all deaths.…”