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Li and colleagues put up a timely article on the stroke burden of China. India, the neighboring country with a huge population, shares similar health problem.1 Overall, 7.3% of all deaths and 3.5% of DALY are attributable to stroke in the country.2
In response, India has been implementing the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) since 2010.3 Under the program, NCD Clinics have been set District and Community Health Centre level across the country for early detection, referral and management of all common NCDs, including stroke. Though prevention and health promotion are the primary focus, there is provision for ICU care at District level for acute cases. With free diagnostics and drugs, the challenge India faces is to bring patients during golden hours to Emergency Room. A few states are implementing a 'hub and spoke' model for providing care in acute cases at the periphery.4 However, in the absence of wider facilities for telemedicine, such models need to depend on remotely stationed neurologists for interpretation of a CT scan.
Recently, a screening program was launched for early identification of non-communicable diseases (NCDs), including diabetes and hypertension, for people above 30 years of age. The strategy is expected to find out suspected and 'at risk' cases and refer them timely to the nearest health centres.5 With simultaneous strengthening of tertiary centres for providing thrombolysis, India is gearing up for mitigating the stroke challenge.
References
1. Li Zixiao, Jiang Yong, Li Hao, Xian Ying, Wang Yongjun. China’s response to the rising stroke burden. BMJ 2019; 364 :l879
2. Indian Council of Medical Research, Public Health Foundation of India, and Institute for Health Metrics and Evaluation. India: Health of the Nation's States - The India State-level Disease Burden Initiative. New Delhi, India: ICMR, PHFI, and IHME; 2017.
3. Government of India. National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke – Operational Guidelines (Revised – 2013-17). New Delhi. 2013.
4. Sharma S, Padma M V, Bhardwaj A, Sharma A, Sawal N, Thakur S. Telestroke in resource-poor developing country model. Neurol India 2016;64:934-40.
5. Directorate General of Health Services. National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke: Training module for Medical Officers for Prevention, Control and Population Level Screening of Hypertension, Diabetes and Common Cancers (Oral, Breastand Cervical). New Delhi: Ministry of Health & Family Welfare; 2017.
Stroke burden in India and strategies for mitigation
Li and colleagues put up a timely article on the stroke burden of China. India, the neighboring country with a huge population, shares similar health problem.1 Overall, 7.3% of all deaths and 3.5% of DALY are attributable to stroke in the country.2
In response, India has been implementing the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) since 2010.3 Under the program, NCD Clinics have been set District and Community Health Centre level across the country for early detection, referral and management of all common NCDs, including stroke. Though prevention and health promotion are the primary focus, there is provision for ICU care at District level for acute cases. With free diagnostics and drugs, the challenge India faces is to bring patients during golden hours to Emergency Room. A few states are implementing a 'hub and spoke' model for providing care in acute cases at the periphery.4 However, in the absence of wider facilities for telemedicine, such models need to depend on remotely stationed neurologists for interpretation of a CT scan.
Recently, a screening program was launched for early identification of non-communicable diseases (NCDs), including diabetes and hypertension, for people above 30 years of age. The strategy is expected to find out suspected and 'at risk' cases and refer them timely to the nearest health centres.5 With simultaneous strengthening of tertiary centres for providing thrombolysis, India is gearing up for mitigating the stroke challenge.
References
1. Li Zixiao, Jiang Yong, Li Hao, Xian Ying, Wang Yongjun. China’s response to the rising stroke burden. BMJ 2019; 364 :l879
2. Indian Council of Medical Research, Public Health Foundation of India, and Institute for Health Metrics and Evaluation. India: Health of the Nation's States - The India State-level Disease Burden Initiative. New Delhi, India: ICMR, PHFI, and IHME; 2017.
3. Government of India. National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke – Operational Guidelines (Revised – 2013-17). New Delhi. 2013.
4. Sharma S, Padma M V, Bhardwaj A, Sharma A, Sawal N, Thakur S. Telestroke in resource-poor developing country model. Neurol India 2016;64:934-40.
5. Directorate General of Health Services. National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke: Training module for Medical Officers for Prevention, Control and Population Level Screening of Hypertension, Diabetes and Common Cancers (Oral, Breastand Cervical). New Delhi: Ministry of Health & Family Welfare; 2017.
Competing interests: No competing interests