Tamar Kahn: Business Day, 27 October 2006

EXPERTS at the World Congress on Stroke have warned that strokes are killing and maiming an increasing number of South Africans as under-resourced health facilities battle to help a population that is rapidly assuming a risk-laden lifestyle. The disease is the third-highest cause of death in SA, after AIDS and heart disease, according to the Medical Research Council (MRC). Of the 500 000 deaths recorded in 2000, 6,5% were due to stroke, 6,6% to heart disease, and 25,5% to AIDS, the MRC's Prof Debbie Bradshaw told delegates. Stroke mortality was highest among black Africans and coloureds and lowest among whites, she said. High blood pressure, smoking, high cholesterol, obesity, diabetes, physical inactivity and a diet lacking fruit and vegetables were among the factors that increased the likelihood of stroke, according to recent research, said Bradshaw, who heads the MRC’s burden of disease unit. The findings on alcohol consumption were mixed, she said, as moderate alcohol consumption appeared to offer some protection, while higher consumption increased the risk of stroke. The congress declared stroke in SA a "catastrophic disease" in a bid to raise awareness about its dangers. The World Stroke Federation president Antonio Culebras said that stroke was a catastrophic illness everywhere, but more so in developing countries. Four-fifths of the 5,7-million annual deaths from stroke occurred in low- and middle-income countries, he said, citing World Health Organisation figures. The social impact of stroke can be measured with Disability Adjusted Life Years (Daly) per 1 000 population, a system that captures the years lost to premature death and lost productivity. A high Daly for stroke means the disease is taking a high toll. According to the WHO, the Daly for stroke in SA was 11, compared with just four for the US and Europe, said Culebras. Other developing nations such as India and China also fare badly, with scores of 10 and 12 respectively.