India unveils plans to improve stroke research and careстатья из журнала
Аннотация: India has begun a nationwide effort to collect stroke data in a bid to improve epidemiological research and care for the disorder. Tamoghna Biswas reports from Kolkata. India has launched a National Stroke Registry Programme to generate “reliable data on the magnitude and incidence of stroke” and to follow the “patterns of care in patients” with the long-term goal of improving epidemiological and clinical research in the country. According to the Global Burden of Disease Study 2010, stroke is the leading cause of disability-adjusted life years (DALYs) in southeast Asia. In 2004, the Indian Council of Medical Research (ICMR) estimated that among all the non-communicable diseases, stroke caused around 41% of deaths and 72% of DALYs in India. Shyamal Kumar Das, Head of the Department of Neuromedicine, Burdwan Medical College, West Bengal, and member of the Research Area Panel on Stroke, says “the disease burden of stroke in India, assessed by DALYs is significantly high. We did a prospective community-based study from 2002 to 2005 to find out the major neurological disorders in Kolkata. Stroke and epilepsy were found to be the most common disorders. The age-standardised average annual incidence rate was 145, and the 30-day case fatality rate at 41% was one of the highest in the world.” The National Centre for Disease Informatics and Research (NCDIR), Bangalore, a centre of the ICMR, launched the website of the new stroke programme and invited registrations from “multiple categories of medical personnel”. The decision to launch the registry followed recommendations by the Research Area Panel on Stroke. Already in India, a few state or city-based stroke registries like the Mumbai Stroke Registry have been successfully operating, propelling the present programme to create an integrated national database. All participating centres have been invited to complete forms for all cases of stroke diagnosed on or after Jan 1, 2013. Though the exact details are yet to be formulated, the registry will consist of population-based stroke registries and hospital-based stroke registries. The location of population-based registries will depend on the number of participating centres and individuals in the area. NCDIR will act as the sole custodian of the data, which will be encrypted upon entry into the system to prevent breaches in confidentiality. “A registry system provides general information with regard to incidence rates, stroke subtypes, and case fatality”, says Chandrakant S Pandav, Head of the Centre for Community Medicine at the All India Institute of Medical Sciences, New Delhi. Arun Kumar Sharma, a professor at the Department of Community Medicine, University College of Medical Sciences, New Delhi, says that “unlike the piece-meal and patchy data available from periodic surveys, a registry will provide a more accurate and complete picture due to involvement of a large quantum of the population”. “The planned creation of a stroke registry will provide a solid foundation for surveillance to track impact on addressing stroke over time—making such registries vital, if neglected, tools for public health in the 21st century”, says Sandeep Pavan Kishore, chair of the Advisory Council, Young Professionals Chronic Disease Network. The significance of the registry system is not only epidemiological; it can also help improve the long-term care of patients. “In our 7-year longitudinal population-based study we found long-term survival rates similar to developed countries”, explains Das. “Many stroke survivors develop post-stroke cognitive impairment, too. Moreover, long-term care-giving can often become a problem due to financial constraints.” Pandav states that a registry system can help practitioners track their patients and allow them to identify the need for follow-up services and improve the quality of care. However, some experts feel that several other factors need to be carefully considered. Pandav, who is also the National President of the Indian Public Health Association, points out his concern: “The amount of resource spent for setting up a stroke registry system should be carefully evaluated against other competing priorities like maternal and child health and vital events registration rather than jumping into such a resource intensive exercise without a significant gain.” He adds: “Establishing the stroke registry system would be a great initiative for the policy makers for better understanding of the epidemiology of stroke but it has to be well thought out and balanced against the basic requirement and need of the country in the field of health and research.”
Год издания: 2013
Авторы: Tamoghna Biswas
Источник: The Lancet
Ключевые слова: Acute Ischemic Stroke Management
Другие ссылки: The Lancet (HTML)
PubMed (HTML)
PubMed (HTML)
Открытый доступ: closed
Том: 381
Выпуск: 9862
Страницы: 190–190