By Sola Ogundipe

A PROFESSOR of Medicine (Neurology) at the College of Medicine, University of Ibadan, Professor Adesola Ogunniyi, has called on the Federal government to make the management of stroke affordable and accessible to Nigerians by putting in place adequate facilities in public hospitals. Ogunniyi, who is also a Consultant Physician/Neurologist at the University College Hospital, UCH, Ibadan,  said the  huge economic burden of stroke in Nigeria could be checked  if more patients are effectively managed in government hospitals.

Speaking in Lagos last week during the 8th Pfizer Cardiovascular Summit, with theme “All About Stroke” organised by Pfizer,  he remarked that it was essential for stroke patients to have access to proper stroke management inpublic hospitals in order to reduce the burden of the condition on the patient and on the country.

At the forum,  designed as an educational platform for healthcare practitioners to engage in a robust discussion on latest trends in Cardiovascular Diseases, Ogunniyi, in a paper entitled “Burden of Stroke in Nigeria”, remarked that ideally treatment of stroke shoud be carried out in the government hospital because it would be a lot cheaper and would not be subject to vagaries of the market.

“Stroke is more a disease of older people but we see it in younger people. As people age they have preposition to develop it. Everybody should know their health status. They should have checks done regularly and should avoid the risks that could lead to stroke.” Ogunniyi said stroke should be avoided because between one-fifth and one-third of those who develop stroke eventually die, so it is a labour loss to the nation because people who should be economically productive are succumbing.

Hugeburden

“Stroke is currently a major burden in Nigeria in terms of number of cases, the associated disability and economic costs. As the population ages, the burden will increase.

“Managing stroke constitutes a huge direct cost burden unaffordable by an average Nigerian stroke sufferer. The implication is that lack of means for rehabilitative care may result in disability adjusted life years which further compounds burdens in terms of indirect cost on the sufferers’ and care givers’ productivity.”

Quoting a study entitled: “Cost Burden of Post Stroke Condition in Nigeria: A Pilot Study”, he said the average cost of care within the first 36 weeks of treatment in government hospitals amounted to  N95,100.00 ($600), while in private hospitals, the average cost is N767,900.00 ($4,860).

Still quoting from the study, he observed that with a prevalence 193,800 cases, 91,800 new stroke cases are expected per year in Nigeria, and with a stroke prevalence of 1.14 per 1,000 population, the average cost of care for the condition in government hospitals is about  N12.1 billion  ($55.08 million) while the cost of private care is N100.98 billion($459 million).

“The cost calculations are different because in public hospitals you spend less and they may not do as many investigations as in the private hospitals. Overall, the difference is almost 700 to 5,000, that is a ratio of 1:7.

Health promotion: He said the import of the current development is that government should improve facilities in its hospitals so that more patients are managed. Government should also put more energy and effort into promoting good health so health promotion is the key, so that we have to spend less on looking after stroke patients.

Strokepatients

He said Nigeria must take a cue from health promotion through education, blood pressure control, dietary restrictions and physical activities, which are  all proven measures designed to reduce stroke incidence.

Global perspective: In his presentation titled: “Cardiovascular Management of Stroke – A Global Perspective”, Emeritus Professor of Medicine at the University of California,  San Fransisco, Prof. David Waters, described stroke as one of the two biggest causes of death and  cause of disability.

“The important message is that stroke can be prevented. If people control their blood pressure, cholesterol and do everything to minimise their other risk factors, the risk of stroke will go down. “It is a shame if you have someone that is relatively productive and is not too old but as a result of a massive stroke becomes disabled because this is something that can be prevented,” Waters remarked.

In a statement, Marketing Director for Pfizer West and East Africa, Mr. Winston Ailemoh said: “Pfizer will continue to invest in Nigeria to support initiatives that can help save lives. The Cardiovascular Summit in its 8th Edition is one of such long term investment. We are committed to also continually support the practice of medical specialists like Cardiologists and Neurologists.”