India cases of stroke, headache and epilepsy more than doubled in 30 yrs: Lancet
The paper provides the first comprehensive estimates of disease burden from neurological disorders and their trends in every state of India from 1990 to 2019
The rate of non-communicable neurological disorders and neurological injuries (of the total disease burden) has more than doubled -- from 4% to 8.2% -- between 1990 and 2019 in the country, finds the India State-Level Disease Burden Initiative in a new scientific paper published in The Lancet Global Health.
Stroke (37.9%), headache disorders (17.5%), and epilepsy (11.3%) are the leading contributors to neurological disorders burden in India, with stroke having caused 699,000 deaths in India in 2019, which was 7.4% of the total deaths in the country. Stroke also caused 68% of deaths due to neurological disorders, followed by Alzheimer’s and other dementias (12%), and encephalitis (5%).
According to the paper, the total neurological disorders burden due to non-communicable disorders is 82.8%; 11.2% is due to communicable and 6% is injury-related disorders. The paper provides the first comprehensive estimates of disease burden from neurological disorders and their trends in every state of India from 1990 to 2019.
These neurological disorders include non- communicable neurological disorders (stroke, headache disorders, epilepsy, cerebral palsy, Alzheimer’s disease and other dementias, brain and central nervous system cancer, Parkinson’s disease, multiple sclerosis, motor neuron diseases, and other neurological disorders), communicable neurological disorders (encephalitis, meningitis, and tetanus), and injury-related neurological disorders (traumatic brain injuries and spinal cord injuries).
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“While communicable diseases contributed to the majority of total neurological disorders burden in children younger than 5 years, non-communicable neurological disorders were the highest contributor in all other age groups,” said the paper.
It mentioned that among the known risk factors for neurological disorders burden, high blood pressure, air pollution, dietary risks, high fasting plasma glucose, and high body-mass index are the leading contributors.
“The analysis in this paper highlights key issues related to trends of neurological disorders in the states of India. Epilepsy is a common neurological disorder in India. While the prevalence of epilepsy has increased over the past three decades, it is gratifying to note that India has made some gains in reducing premature deaths and morbidity of people with epilepsy over this period by reducing treatment gaps,” said Gagandeep Singh, professor, Dayanand Medical College, and the first author of the paper.
“There is, however, a need to scale up treatment coverage of epilepsy in governmental schemes such as the Rashtriya Bal Swasthya Karyakram and Ayushman Bharat. Policies and practices focusing on safe births, preventing head injury and stroke would help in averting a substantial proportion of epilepsies,” he added.
“As the burden of an increase in neurological disorders faces our population it is high time that prevention and early management which are key in reduction in neurological burden are galvanised. On the prevention slide simple lifestyle modifications like a healthy diet, healthy oils, no smoking, blood pressure control, diabetes prevention, and management weight control by walking; avoiding refined foods like maida, sugar etc.; staying physically active; managing obstructive sleep apnea; and reducing stress etc. ,” said Dr Manjari Tripathi, professor, department of neurology, All India Institute of Medical Sciences, Delhi. She is also a co-author of the study paper.
“Early treatment can save irreversible damage be it from stroke, epilepsy, status epilepticus etc as time is crucial, with neurons (nerve cells) once lost do not replenish and regain function again,” added Dr Tripathi.
The paper is a collaborative effort between the Indian Council of Medical Research, Public Health Foundation of India, Institute for Health Metrics and Evaluation, and a number of other key stakeholders in India, including academic experts and institutions, government agencies and other organisations, under the aegis of the ministry of health and family welfare. At least 300 leading scientists and experts representing about 100 institutions across India are engaged with this collaborative work.