Burden of Stroke in Myanmar

Abstract

Myanmar is home to over 51 million people. The age- and sex-standardized mortality rate due to stroke is 165.4/100,000, while the rate of age- and sex-standardized disability-adjusted life years lost due to stroke is 2971.3/100,000. The prevalence of stroke among adults aged 40–99 years is 1.5%. Stroke is the leading cause of morbidity and mortality and comprises 20% of the neurological workload. There are only 10 stroke units in the whole country. Doctors are aware of the importance of hypertension in stroke prevention and the need for physiotherapy after stroke, but, until recently and in rural areas, they also tend to use steroids and neuroprotectants, and lower blood pressure aggressively acutely after stroke; antiplatelets are not widely used. Thrombolysis service is available at some tertiary centers but mechanical thrombectomy is not yet available.

A descriptive study of stroke types, risk factors, clinical features, and outcomes in a tertiary hospital in Myanmar

“…This difference could be due to a selection bias of the study setting; specifically, the Nay Pyi Taw General Hospital is one of four public hospitals in the country with neurology departments and neurosurgical departments for the optimal care of haemorrhagic stroke cases. In Myanmar, stroke cases are typically managed by internists in urban areas and general practitioners in rural areas [ 13 ]. However, when neurosurgical interventions are necessary for haemorrhagic stroke patients, they are referred to hospital which have a specialized department.…”

Stroke systems of care in South-East Asia Region (SEAR): commonalities and diversities

“… 62 There are 56 neurologists and 27 neurosurgeons in the country but stroke patients are also managed by general physicians in secondary hospitals. 63 Although thrombolysis is currently offered in 11 hospitals, EVT is unavailable. 63 Since the launch of the National strategic rehabilitation plan, post-stroke rehabilitation has steadily improved, however, a lack of OTs and SLTs remains.…”

“… 63 Although thrombolysis is currently offered in 11 hospitals, EVT is unavailable. 63 Since the launch of the National strategic rehabilitation plan, post-stroke rehabilitation has steadily improved, however, a lack of OTs and SLTs remains. 64 The WHO-SEARO-CMCL project undertook to strengthen and improve the existing systems within the country with a standardized capacity-building program to develop evidence-based stroke-care protocols, strengthen the rehabilitation workforce, and establish a stroke registry.…”