Experts want greater action on stroke registry, faster response mechanism for patients

Ahead the 2015 World Stroke Day, stakeholders in the healthcare sector are urging greater action in the establishment of a stroke registry for Nigeria.

They are also calling attention to the need for more education for healthcare practitioners and conduct serious advocacy for Nigerians to mitigate the effects of stroke.

Consultant Neurosurgeon and Member of the Nigeria Stroke Reference Group, Dr. Biodun Ogungbo, postulated these issues in a press release to enhance public enlightenment on stroke care in Nigeria.

He noted: “The government recently inaugurated a special group, the Nigeria Stroke Reference Group (NSRG) to help deliver a strategic plan and direction for stroke care in Nigeria. It will liaise with the Federal Ministry of Health (FMOH) to deliver a stroke registry for Nigeria, educate healthcare practitioners and conduct serious advocacy for Nigerians to mitigate the effects of stroke.

“There are a few pertinent things for Nigeria. We need to develop an emergency telephone number for Nigeria and a coordinated ambulance service as well. You see, to treat stroke effectively, the stroke victim should be able to call an emergency response number and be transported to a dedicated stroke centre within minutes, for clot bursting drugs to be administered.”

On how the Centre could operate, he stressed: “At the stroke centre, a brain scan is mandatory and must be performed immediately to see what type of stroke the person has suffered. Then, if suitable and within the recognised time window of about three to four hours, clot bursting drugs can be given to reopen the pipes that are blocked in the brain. In some situations, this leads to immediate recovery from the stroke.

“The clot bursting drugs such as Alteplase, Streptokinase and Urokinase are not readily available. Where they are available, they are too expensive for the common man to buy. For the rich who have money to fly out of the country, Europe, America and India are too far to go for a drug that must be administered within three hours. In effect, developing a local solution to cater for everyone favours both the rich and the poor.”

He provided further information on stroke. His words: “A stroke is a ‘brain attack’ and can happen to anyone at any time. It occurs when blood flow to an area of brain is cut off. When this happens, brain cells are deprived of oxygen and begin to die. When brain cells die during a stroke, abilities controlled by that area of the brain such as memory and muscle power are lost.

“It is a leading cause of long-term disability and death. Each year, more than 160, 000 Nigerians die from stroke though we do not know the actual number. This is more than Malaria and HIV combined anyway. However, stroke is not truly recognized as a killer and given the due dishonourable credit it deserves. Many of the deaths and disability is often ascribed to Malaria and witchcraft.

“For survivors and their families, the long-term costs, both financial and in terms of quality of life, are often overwhelming. Over two-thirds of survivors must live with chronic conditions, such as paralysis and reduced physical activity, speech problems, and the ability to understand speech. These conditions can impact an individual’s ability to return to work, return to school, and become a functioning member of society once again.”

He went on: “World Stroke Day is a time to raise awareness for the devastating impact, causes, and symptoms of stroke. As our leader, you must ensure Nigerians understand that stroke is treatable and preventable, as long as citizens arm themselves with the proper diagnostic tools and health information.

“Common stroke symptoms include: sudden weakness of the face, arm, or leg; sudden confusion; trouble speaking or understanding speech; sudden trouble walking or seeing; loss of balance; and sudden, severe headache. The ability to recognize these symptoms and seek medical attention immediately is critical to surviving a stroke and minimizing long-term disability.

“Stroke affects people of all ages, but several underlying factors that put individuals at higher risk include high blood pressure, diabetes, high cholesterol levels, obesity, tobacco use and physical inactivity. Understanding the risks involved with certain lifestyle choices and making healthier choices can often help reduce a person’s risk of stroke.”

He added: “Everyone must know the root causes of stroke such as high blood pressure and diabetes. High blood pressure or hypertension is the biggest underlying cause of stroke in Nigeria. Many people do not know they have high blood pressure because they have not checked. We need to change this. Others who have been diagnosed stop taking medications for various reasons. Some because their pastor said they were cured at the last retreat!

“Many nations are concentrating on the advocacy and effective treatment in stroke centres. We know that treatment in a stroke centre reduces the disability and death significantly. Therefore establishing such centres in Nigeria is the way forward. So, stroke centres need to be developed to provide effective emergency management of stroke victims. Some centres exist in Benin and Abeokuta but they need serious financial support to deliver quality of care.

“The government through the FMOH must find ways to effectively support stroke survivors and their families through the advancement of new treatments. By raising awareness, we can minimize the rates of disability and mortality resulting from stroke.”

He stressed that October 29 had been set aside to mark the day at the Transcorp Hilton, Abuja.