In 2019, the largest contributors to the total neurological disorder DALYs in India were stroke (37·9%), headache disorders (17·5%), epilepsy (11·3%), cerebral palsy (5·7%), and encephalitis (5·3%)
New Delhi: The contribution of non-communicable and injury-related neurological disorders to the total disease burden in India has more than doubled between 1990 and 2019, revealed a study published in The Lancet Global Health on Wednesday.
Stroke caused 699,000 deaths, which was 7.4% of the total deaths in the country in 2019.
“The contribution of non-communicable neurological disorders to total DALYs (disability adjusted life-years) in India doubled from 4·0% in 1990 to 8·2% in 2019, and the contribution of injury-related neurological disorders increased from 0·2% to 0·6%," the study said.
These neurological disorders include non-communicable neurological disorders (stroke, headache disorders, epilepsy, cerebral palsy, Alzheimer’s disease and other dementias, brain and central nervous system cancer, Parkinson’s disease, multiple sclerosis, motor neuron diseases, and other neurological disorders), communicable neurological disorders (encephalitis, meningitis, and tetanus), and injury-related neurological disorders (traumatic brain injuries and spinal cord injuries).
The first comprehensive estimates of disease burden due to neurological disorders and their trends in every state of India from 1990, a part of the Global Burden of Disease Study 2019, were published by the India State-Level Disease Burden Initiative a joint initiative of Indian Council of Medical Research (ICMR) along with other public health institutions.
According to the study, in 2019, the largest contributors to the total neurological disorder DALYs in India were stroke (37·9%), headache disorders (17·5%), epilepsy (11·3%), cerebral palsy (5·7%), and encephalitis (5·3%). Stroke, headache disorders, and epilepsy are the leading contributors to neurological disorders burden in India, the study said adding that
“Headache is the commonest neurological disorder affecting 1 in 3 Indians, and is often neglected in terms of public health priority. It is the second leading contributor to the disease burden from neurological disorders in India. Migraine affects females more than males, greatly affecting adults in the working age population. Headaches, especially migraine, need to be recognised as a public health problem and included under the national NCD programme," said N Girish Rao, professor, National Institute of Mental Health and Neuro Sciences, and a co-author on the paper.
Authors also said that the burden of non-communicable neurological disorders is increasing in India mainly due to ageing of the population. Among the known risk factors for neurological disorders burden, high blood pressure, air pollution, dietary risks, high fasting plasma glucose, and high body-mass index are the leading contributors, the study said.
“Neurological disorders contribute 10% of the total disease burden in India. There is a growing burden of non-communicable neurological disorders in the country, which is mainly attributable to ageing of the population," Balram Bhargava, Secretary to the Government of India, Department of Health Research, Ministry of Health & Family Welfare, and Director General, ICMR said.
Vinod Paul, member (health), NITI Aayog said “Several government policies and initiatives are in place to address the burden of neurological disorders across India, however more focused efforts are required for the planning of specific neurology services in each state. There is a need to address the shortage of trained neurology workforce, and strengthen early detection and cost-effective management of neurological disorders in the country to deal with their growing burden."
While communicable diseases contributed to the majority of total neurological disorders burden in children younger than five years, non-communicable neurological disorders were the highest contributor in all other age groups, the study said.
“While the burden of infectious neurological disorders has fallen in India, this burden is higher in less developed states. On the other hand, the burden of neurological disorders related to injury is higher in more developed states. Among non-communicable neurological disorders, stroke is the third leading cause of death in India, and dementias are the fastest growing neurological disorder," Lalit Dandona, director of the India State-Level Disease Burden Initiative, scientist at ICMR, distinguished professor at public health foundation of India (PHFI), and senior author of this paper said.
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