In a 2022 report by Rwanda Biomedical Centre (RBC), it was revealed that stroke-related deaths in Rwanda escalated from the seventh position in 2009 to the third in 2019, becoming a significant cause of mortality, representing 5.1 per of total deaths.
The report highlights that the median delay in seeking medical attention in Rwanda is 72 hours for ischemic stroke patients and 24 hours for those with haemorrhagic stroke. Despite Rwanda’s efforts to combat non-communicable diseases (NCDs), the fatality rate from strokes continues to rise. Stroke remains the third leading cause of death in Rwanda, underscoring the pressing need to alleviate its impact on the population.
In light of this, Rwanda anticipates implementing the ‘Act FAST’ campaign—a public health initiative aimed at raising awareness about the signs of stroke and the importance of acting quickly—in 13 districts to control 12,685 cases of hypertension— a major risk factor for stroke—per year.
Rwanda Biomedical Centre recommends policy formulation and endorsement, revising NCD guidelines and protocol that include the management of stroke, improving data capturing to avail stroke, prioritising. It also calls for allocating a budget for stroke prevention related activities and engaging stakeholders to enhance mobilisation to prevent stroke, and considering stroke day among annual diseases events.
Stroke and young people
A stroke is an acute loss of neurological function due to an interruption of blood supply to the brain. As per the World Health Organization (WHO), stroke is the leading cause of disability worldwide and the second leading cause of death.
Stroke in young individuals is becoming a growing concern in developing and developed nations partly attributed to a rise in the prevalence of traditional risk factors including hypertension, obesity, diabetes, smoking and heart disease.
In comparison to strokes in the elderly, strokes in young individuals are more varied because of the numerous potential risk factors and causes, as reported by the Journal of Neurology, Neurosurgery, and Psychiatry.
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The World Health Organization states that annually, 15 million people worldwide suffer a stroke. Of these, five million die, and another five million are left permanently disabled.
High blood pressure and tobacco use are the most significant modifiable risks. For every 10 people who die of stroke, four could have been saved if their blood pressure had been regulated.
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Dr Joseph Rukelibuga, Legal Representative of Stroke Action Rwanda, an NGO founded by stroke survivors in Rwanda to fight cerebrovascular accidents (stroke) through prevention, treatment, and long-term care and support, explained that the cases of stroke among young adults are due to an upsurge of risk factors among this group of population because of lifestyle change.
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He noted that eating unhealthy food such as high-fat, high-salt, high-sugar, or processed foods can directly contribute to an escalation of plaque in the arteries. As this plaque blocks and tightens blood flow throughout the body, the result is an intensely higher risk for heart disease, heart attack, and stroke.
"Poor stress management can cause the heart to work harder, increase blood pressure, and upsurge sugar and fat levels in the blood. This can increase the risk of clots forming and travelling to the heart or brain, causing a heart attack or stroke.”
Dr Gerald Urimubenshi, a stroke rehabilitation expert and senior lecturer at the University of Rwanda, said that an unhealthy diet, and consumption of food with too much salt and oil are linked to stroke among young people.
He added that low physical activity, or inactivity, for example not walking, sitting for long while watching TV, or engaging in activities that don’t require physical activity can contribute to an increase of cholesterol in the body. If cholesterol level is too high, it may boost the risk of stroke. In fact, high cholesterol is not healthy, because it can lead to the development of fatty deposits in blood vessels. Eventually, these deposits grow, hindering enough blood to flow through one’s arteries. The deposits can break suddenly and form a clot that causes stroke.
He noted that drinking too much alcohol can increase one’s risk of stroke. Research shows that globally, excessive alcohol consumption is linked to over one million strokes each year.
Stroke isn’t a condition for old people, thus the need for a change of mind-set. Stroke is common in all continents especially low medium countries. It is, therefore, advised to prevent it by eating healthy food such as vegetables, fruits, and white meat and decreasing consumption of red meat, Urimubenshi stressed.
He urges controlled drinking, not going beyond two glasses for a 4 per cent alcohol content.
"Physical activity is very important, eating without exercising hinders an individual from acquiring great components. Not exercising, or getting physical activity is a confirmed risk factor of premature death.”
Some studies show that inactivity and being sedentary cause more deaths around the world than cigarette smoking or diabetes.
For secondary prevention, Urimubenshi advises seeking immediate help once one notices the stroke signs. The acronym FAST can help one remember the most common signs of a stroke and what to do if you think you or someone else is having a stroke: