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Time matters: Improving Awareness to Reduce Stroke Mortality

Dushimiyimana Valentine1,*, Nyarko Kwame2, Hakizimana Moussa3, Ndishimye Pacifique1, Nshimiyimana Ladislas1, Karame Prosper1, Musanabaganwa Clarisse1, Ntaganda Evarist1, Rwunganira Samwuel1,Rwagasore Edson1, Niyonsenga Simon Pierre1, Ngoboka Godfrey1, Uwinkindi Francois1, Tuyishime Albert1, Ndayisaba F. Gilles1, Bigirimana Noella1, Nsanzimana Sabin1
1Rwanda Biomedical Centre, Kigali, Rwanda
2University of Rwanda, Kigali, Rwanda
3CDC Foundation-Rwanda

Key Messages
Stroke kills an estimated 5 million people worldwide each year, with developing countries contributing 3.3 million; the number one cause of stroke is hypertension.
Stroke deaths moved from the 7th (2009) to the 3rd (2019) place as a leading cause of mortality in Rwanda, counting for 5.1% of total deaths. Provider adherence to screening and treatment protocols can help to control hypertension and its complications in Rwanda.
Improving public awareness of the causes and symptoms of stroke can prevent over 130 stroke deaths per year.

Problem Statement
A stroke is an acute loss of neurological function due to an interruption of blood supply to the brain. It is the second leading cause of mortality worldwide (5 million annual deaths) [1], the second most common cause of disability (116.4 million Disability Adjusted Life Years (DALYs), and a major public health challenge [2,3] and low and middle-income countries contribute 66% of all stroke deaths worldwide [4]. In the absence of a significant global public health response, projections show that stroke mortality will increase faster in middle and low-income countries than in high-income countries by 2030 (Figure 1) [5]. In 2019, there were 2,915 deaths from stroke in Rwanda, counting for about 5% of total deaths.
Research suggests that the first hour between symptoms onset and clinical care is critical and the gold standard response time [6]. In Rwanda, the median presentation delay is 72 hours for patients with ischemic stroke and 24 hours for patients with hemorrhagic stroke [7]. Although Rwanda has put efforts into the prevention of non-communicable diseases (NCDs), the percentage of deaths due to stroke is still increasing. It remains Rwanda's third leading cause of death (Figure 2) [8]. There is an urgent need to reduce the burden of stroke in Rwanda.

Category: Policy brief

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