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‘Less than 1% of stroke patients in India get treatment within golden window’

Indian Express 2019-03-14 07:14:06
Stroke, that apparently affects 130 persons per one lakh population in India, remains to be a priority for the government as policy-level lacuna exists.

Less than one per cent of stroke patients in India get right treatment within the golden window of four-and-a-half hours after an attack. Doctors revealed this ahead of a three-day Indian National Stroke Conference, which will be organised in the city from March 15.

“Only 31 per cent people are aware of the golden window of four-and-a-half hours after an attack. After this, time loss is brain loss (damage),” said neurologist Dr Arvind Sharma, who is an executive committee member of Indian Stroke Association that is organising the conference, Wednesday.
Dr Vijay Sharma, professor of neurology at National University of Singapore, who was also present at the press conference Wednesday, said currently 10-15 per cent of patients in India reach hospital within the golden window and are treated with clot buster medicines. “But this number only includes big cities that too some 10 to 15. Even then, there are only a few hospitals which are able to provide this treatment timely. So, overall the number of patients who find the right treatment within the golden window, do not even make one per cent,” said Dr Vijay, adding one of the biggest risk factor for stroke is aging even though there are incidence of strokes affecting people below 40 years of age.

But, Dr Arvind said, making treatment available in rural areas is the biggest challenge. “What I believe is, for the 80 per cent population, including rural, who can’t reach a stroke-ready centre within the golden window, we should at least start physiotherapy centres for preliminary treatment and to determine what kind of stroke it is. Following this, the patients must be given anti-platelets medicine so that the stroke doesn’t reoccur. At village level, however, there are not even any physiotherapy centres. Without at least such a mechanism, a person becomes prone to repeated strokes without knowing the cause or risk factors,” he said, adding for a hospital to be ready for treating strokes, it must at least have CT scan facility.

Another challenge, Dr Arvind said, is doctors’ efficacy in rural areas. “We should have modules to teach them how to get stroke-ready and further, how to refer patients to tertiary health care centres urgently. At present, such a mechanism or module does not exist,” said Dr Arvind.

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Stroke, that apparently affects 130 persons per one lakh population in India, remains to be a priority for the government as policy-level lacuna exists. While, as per the association’s research, the disease claims a patient every 45 seconds in India, stroke is yet to find coverage in PMJAY. “You can see how the government has taken an initiative for non-communicable diseases such as heart attack, cataract and cancer. They should do the same for stroke too. For example, in Shimla, the Himachal Pradesh government has supplied clot buster drugs to every district authority, thereby sensitising all physicians and not merely neurologists. We are trying to implement a similar model in Gujarat where stroke can be treated at district level,” he said.

Dr Vijay added with life expectancy of Indians going up, incidence of strokes are bound to go up. “Furthermore our lifestyle, such as eating junk, is also a risk factor and not being supported by our healthcare standards.”