Until now, little has been known about the burden of stroke in sub-Saharan Africa. The Southern African Stroke Prevention Initiative (SASPI) is a multi-disciplinary study set up to assess the burden and prevalence of stroke in a deprived rural area.
The research revealed that the actual numbers of stroke survivors left disabled was as high in rural South Africa as New Zealand, a typical developed country. Frequently viewed as a chronic illness of affluent countries, stroke is exposed as a significant cause of illness and disability in the developing world, and this impact is set to worsen.
The individuals surveyed were defined as disabled if he or she needed assistance washing, dressing, bathing, feeding, mobility or going to the toilet.
Within the area of the Southern African Stroke Prevention Initiative (SASPI), which has a population of 68 525, there is a stroke prevalence of 300 per 100 000 people. Of these stroke survivors 200 per 100 000 people (66%) were disabled.
Although more people suffer strokes in high-income countries, far less people are disabled by the condition. In New Zealand the proportion of stroke survivors who need help with a daily living activity is much lower (22%).
The numbers of stroke sufferers in rural South Africa and other African countries are set to grow as the age of the population increases, and undergoes a transition from predominantly infectious diseases to noncommunicable diseases, and most will have no access to life-improving or lifesaving treatment.
Professor Margaret Thorogood, from the University of Warwick, said: "The major burden of a stroke is not death, but chronic disability, and the percentage of sufferers disabled following a stroke is much higher in rural South Africa than in the developed world. Poverty-stricken Africa already suffers from a huge burden of HIV/ AIDS, and it now faces a looming epidemic of vascular disease. Left unchecked the impact could be massive."
Stroke is a leading world-wide killer that now threatens Southern African countries. African governments must recognise stroke treatment as an urgent priority as epidemics of stroke and other chronic diseases are set to create a health crisis, reveals the report.
The prevalence of disabled stroke survivors has important implications for health care systems that need adapted to facilitate early treatment and rehabilitation. New care strategies are needed, as effective secondary prevention may reduce the incidence of recurrent strokes. Prevention and control of vascular disease needs acknowledged within health services that utilise early brain imaging, community-based research and detailed study of stroke.
Contacts: Professor Margaret Thorogood, Warwick Medical School, University of Warwick, Tel: 024-7657-4509, Mobile: 0780-110-6647 or Jenny Murray, Communications Office, University of Warwick, Tel: 02476-574-255, Mobile: 07876-21-7740.
"Prevalence of Stroke Survivors in Rural South Africa" is published in Stroke March 2004 See: http://stroke.ahajournals.org.