Stroke replaces diarrhoea as top killer in BD

Stroke was the leading cause of death claiming  178,354 lives in Bangladesh in 2013 replacing diarrheal diseases two decades ago, according to a  new report on country-specific cause-of-death data for 188 countries.
The data was prepared by an international consortium of researchers and coordinated by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.
Treatment of stroke, a medical emergency, must be sought as quickly as possible as it occurs due to problems with blood supply to the brain. Either the blood supply is blocked or a blood vessel within the brain is ruptured.
Fewer people are now dying from diarrheal diseases and preterm birth complications in Bangladesh.
Mortality from diarrheal diseases dropped 91 per cent between 1990 and 2013, it revealed.
At the same time, a number of diseases, including ischemic heart disease and diabetes, claimed more lives in Bangladesh in 2013 than in 1990.
Life expectancy improved for both men and women in Bangladesh, at an average of 11.1 years gained since 1990, a larger increase than the global average, and one of the top 10 biggest gains in life expectancy worldwide, it added.
The report on 'the Cause of Death - Global Burden of Disease 2013' is about global mortality and compares data from 1990 to 2013 and analyses the shift in major causes for death across 188 countries.
The other leading killers in Bangladesh included ischemic heart disease, chronic obstructive pulmonary disease (COPD), pneumonia, interstitial lung disease and diabetes, the report revealed.
Ischemic heart disease and stroke were the top two causes of death for people between the ages of 15 and 49, resulting in loss of 31,724 lives in 2013.
Among individuals, aged 70 and older, stroke claimed most lives in that year. The top cause of child mortality was neonatal encephalopathy in 2013, killing 28,412 children under the age of 5, it added.
In Bangladesh, ischemic heart disease and diabetes took more lives in 2013 than in 1990, with deaths increasing more than 400 per cent and more than 200 per cent, respectively.
Mortality from stroke also increased more than 200 per cent between 1990 and 2013.
Since 1990, Bangladesh saw a marked decline in mortality from a number of diseases that used to take a large toll on the country.
For instance, by 2013, mortality from diarrheal diseases decreased by 91 per cent and preterm birth complications caused fewer deaths. In 1990, these diseases killed 271,569 people. Twenty-three years later, these claimed 235,859 lives.
The study also revealed how some diseases and injuries cause different mortality patterns for males and females. For example, in Bangladesh, ischemic heart disease took a greater toll on men, killing 71,375 males and 35,505 females in 2013. By contrast, stroke claimed 91,809 women's lives and 86,545 men's lives.
Dr Aliya Naheed, Associate Scientist, Centre for Equity and Health Systems, icddr,b  said, "Bangladesh has set an extraordinary example of improving health and life expectancy of its people at a very low cost, and has achieved notable gains in a number of indicators. Bangladesh has outperformed some of its neighbouring countries, which have higher per capita incomes."
"However, the health system has been facing enormous challenges as it caters to more than 150 million people. These challenges will be greater in the future as the population grows, demographics shift, and chronic diseases emerge on top of infectious diseases. The government will need to invest more in primary health care and focus on developing self-sustaining health plans for prevention of both acute and chronic diseases", she said.
Globally, people live an average of 6.2 years longer than they did in 1990, with a life expectancy rising to just under 72 years in 2013.
Women showed a slightly larger average gain (an increase of 6.6 years) than men (a rise of 5.8 years).
Improvements in health, reduced fertility, and shifts in the world's age patterns have driven these global gains in life expectancy, it added.
In Bangladesh, the average life expectancy for women was 71 years in 2013, with men living an average of 68.3 years. By contrast, women lived an average of 59 years and men had a life expectancy of 58.2 years in 1990.
Out of the 188 countries included in the study Bangladesh ranked 126th for women and 108th for men for longest life expectancies.
In 2013, Andorra had the longest life expectancy for women (86.7 years) and Qatar had the longest for men (81.2 years). Lesotho had the shortest life expectancy for both women (51.2 years) and men (45.6 years).
A statement issued by IHME quoting its Director Dr Christopher Murray said, "The fact that people are living longer in most parts of the world is good news but we must do more to address health disparities. Only with the best available evidence can we develop policies to improve health and save lives."
Worldwide, ischemic heart disease, stroke, and COPD claimed the most lives, accounting for nearly 32 per cent of all deaths.
Much global progress has been made in reducing mortality from diseases such as measles and diarrhea, with 83 per cent and 51 per cent declines, respectively, from 1990 to 2013, the report added.
munni_fe@yahoo.com