Abba, 48, suddenly slumped at home after work last year and was rushed to the hospital. He was diagnosed with a stroke and spent weeks in the hospital. It took another 10 months for him to begin to walk unaided and resume his usual activities.
Before then he had always considered himself very healthy, and never checked his blood pressure.
He however considered himself lucky considering the other stroke cases he met during his hospitalisation as some of them suffered disabilities and death.
Maria’s mother on the other hand has been living with a stroke for six years. She recovered after her first stroke in 2016 but suffered another one in 2023. Her recovery so far has been slow. Maria said the family is making concerted efforts to ensure she doesn’t suffer another stroke.
Stroke is one of the leading causes of long-term disability and death. Some experts estimate that more Nigerians die from stroke than malaria and HIV combined.
Experts say the disease is a common cause of death and disability in adults. They say 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.
Stroke can leave victims with long-term health dependence ranging from impaired motor control and urinary incontinence to depression and memory loss. It most often ultimately results in early death in the country.
These conditions can impact an individual’s ability to return to work, return to school, and become a functioning member of society once again. For survivors and their families, the long-term costs, both financial and in terms of quality of life, are often overwhelming.
Stroke is said to occur when the blood supply to the brain is interrupted by factors such as high blood pressure or damage to blood vessels.
According to Stroke Action Nigeria, one in four people will have a stroke in their lifetime. “90% of strokes could be prevented by action on a handful of manageable risk factors including high blood pressure, atrial fibrillation (irregular heartbeat), smoking, diet, and exercise. This year, stroke continues to be the leading cause of death worldwide. The burden of disability after a stroke is also increasing globally and is higher in Africa. More young adults under the age of 55 years are having strokes. Each year over 12 million people have strokes worldwide,” the organisation said.
Stroke Action Nigeria said in Nigeria, a country with over 200 million people, stroke has become an epidemic affecting over 200,000 people each year.
Mortality rates are very high with a range of 21% – 45%. At the Stroke Action Life After Stroke Centres in Nigeria, at least 18 referrals of stroke survivors discharged from hospital care are received each month and majority of the stroke survivors are of working age. Many of the survivors end up with severe disability due to lack of stroke units and stroke rehabilitation services in the country.
Dr Olugbenga Akande, Lead Partner of the International Stroke Protection Centre, Lekki, Lagos, said stroke has remained a silent killer because people do not notice the underlying risks and symptoms until it is too late .
He said stroke could be prevented with early detection, and recognising the warning signs. “Up to 80% of strokes are preventable. Strokes can occur at any age and at any time even in people with a low to medium risk of having it. You could reduce your risk with early assessment, appropriate preventative treatment, screening and lifestyle changes,” he said.
He said the signs of stroke include: loss of strength, numbness, loss of vision, speech difficulty, loss of balance, transient spells including vertigo, dizziness, swallowing difficulties, acute confusion, and memory disturbances, among others.
According to the expert, up to 50% of people who have a stroke in Nigeria are likely to die within 30 days. “Those who survive may have major life changing disabilities and reduced life expectancy. The financial impact on stroke sufferers and their families includes both direct and indirect costs,” he added.
The medical expert said the concern about the burden of stroke in the country made the centre devise effective detection, management and treatment to tackle it.
He said it was also why the centre was offering comprehensive annual stroke preventative assessment and early warning treatments. “These include full neurological and brain screening tests, extensive vascular screening and risk factor review and cognitive enhancement treatment solutions,” he said.
Rita Melifonwu, a Nurse Consultant in Stroke Rehabilitation, Stroke Action Nigeria and Member World Stroke Campaign Committee, said at the World Stroke Congress 2023 in Toronto, Canada, the collaborative World Stroke Organisation – Lancet Neurology Commission published its ‘Pragmatic solutions to reduce the global burden of strokes’.
“They forecast the burden of stroke from 2020 – 2050 and project that stroke mortality will increase by 50% from 6.6 million in 2020 to 9.7 million in 2050. As a result of their assessments, they identified and prioritised several key recommendations based on the four pillars of the stroke quadrangle of: surveillance, prevention, acute care and rehabilitation,” she said.
She said most stroke survivors in Nigeria remain unemployed and are unable to maintain their livelihoods. She said that Stroke Action Nigeria is currently working with Philips Foundation and the organised stroke care across income levels (OSCAIL) to carry out a randomised control trial to evaluate the impact of its Life After Stroke Centre.
In addition, she said the research will be completed in 2024 and results may contribute to benefits of community-based life after stroke centres in Nigeria and Africa.
She said for the next two years, the World Stroke Day Campaign will focus on prevention because of the increasing incidence of strokes globally.
She said Stroke Action Nigeria is mobilising stroke stakeholders nationally and globally to drive awareness and action on stroke prevention and management in Nigeria.
Stroke Action is a member of the Federal Ministry of Health’s NCD expert technical working group that developed the Multisectoral Action Plan (MSAP) on the Control and Prevention of NCDs in Nigeria.
She said, “For the first time in Nigeria, an NCD policy has a stroke mention. Our hospitals and primary healthcare centres should use the MSAP to help facilitate stroke surveillance and prevention.”