By Dr Aung Tun
THE World Stroke Organization (WSO) designates October 29th annually as World Stroke Day to raise awareness about the danger of stroke and the importance of rapid treatment.
The main theme for World Stroke Day 2025 is "Every Minute Counts: Let's Act Together and #ActFAST.
What is a Stroke?
A stroke is a sudden event that interrupts the blood and oxygen supply to the brain. Without treatment, millions of brain cells die within minutes. This time delay causes lasting brain damage that can severely impact a person's ability to walk, speak, and handle daily activities.
Therefore, knowing the signs of a stroke and raising the alarm immediately is the critical first step. It not only saves lives but also significantly increases a stroke survivor's chances of recovery.
Global Stroke Situation
Stroke remains one of the greatest health challenges worldwide:
* Incidence: Around 12 million people suffer a stroke annually, which equates to one person every two seconds.
* Mortality: Approximately one in every two people who have a stroke loses their lives to the disease.
* Sequelae: About two-thirds (2/3) of survivors face long-term complications and disability.
According to data from the Global Burden of Disease Study 2019, stroke remains the second leading cause of death and the third leading cause of disability globally (Lancet, 2020). WSO's 2022 data indicates that about 12.2 million people experience a first-ever stroke each year, 6.5 million die, and 110 million are living as stroke survivors. Stroke incidence has increased by over 100 per cent in low- and middle-income countries over the last 30 years (Feigin et al., 2022).
Stroke in Myanmar
In Myanmar, stroke is a major cause of both mortality and long-term disability. It plays a significant role in the rising Non-Communicable Diseases (NCDs) related deaths.
The Myanmar STEPS Survey 2019 reveals a high prevalence of major stroke risk factors in the population:
| Hypertension (High Blood Pressure) | 20.8 per cent of the population
| Diabetes Mellitus | 10.5 per cent of the population |
| Tobacco Use (Smoking/Other Products) | 21.8 per cent of the population use tobacco products |
| Obesity | Approximately 11.2 per cent of the population is overweight or obese |
These figures demonstrate a significant burden of stroke risk factors in Myanmar, necessitating effective prevention and control measures.
Causes of Stroke
Stroke is mainly classified into two types:
(A) Ischemic Stroke
* Caused by a blockage in a blood vessel supplying the brain.
* Accounts for approximately 87 per cent of all cases.
(B) Haemorrhagic Stroke
* Caused by a blood vessel rupture within the brain, leading to bleeding.
Risk Factors
Key factors that increase the risk of stroke include:
* High Blood Pr e s sure (Hypertension): The single largest risk factor.
* D i a b e t e s Mellitus: High blood sugar damages blood vessels.
* Heart Diseases: Conditions like Atrial Fibrillation (AF) can cause blood clots that block brain arteries.
* Smoking: Including all tobacco products and vaping.
* Obesity and Physical Inactivity.
* Unhealthy Diet: High salt and high fat intake.
* Excessive Alcohol Consumption.
Rapid Diagnosis
Recognizing the signs of stroke is the most crucial step in saving a life. Everyone should remember the WSO-designated acronym, #ActFAST:
| F | Face Drooping | Does one side of the face droop or feel numb? |
| A | Arm Weakness | Is one arm weak or numb? |
| S | Speech Difficulty | Is speech
slurred, difficult, or garbled?
| T | Time to Call | Call immediately for emergency medical help. (Go to the nearest hospital/treatment centre without delay).
If stroke is suspected, do not delay for a single minute; the person must be rushed to the nearest hospital or a specialized stroke unit immediately. If the cause is a blocked artery, administering clot-busting medication (thrombolysis) within the critical "Golden Hour" time limit is vital for effective treatment.
Transient Ischaemic Attack (TIA / mini stroke).
Among the various types of strokes, there is a kind that can be immediately recovered from and leaves no long-term symptoms, and it usually gets better within a short period. This type is called a Transient Ischaemic Attack (TIA / mini stroke).
A stroke (Transient Ischemic Attack) is a small stroke that occurs due to a temporary interruption of blood flow to the brain. Normal blood flow is restored within a short time frame (ranging from 5 minutes to 24 hours), and the symptoms often resolve without medical treatment. However, it is urgently necessary to seek medical treatment to prevent a recurrence of another mini-stroke or a full-blown major stroke.
Challenges for Myanmar
"Relevant hospital treatment centres can provide necessary diagnostic procedures for stroke, including Blood Tests, ECG, Echocardiogram (Echo), MRI, CT Scan, and Angiogram, as required.
MRI and CT Scan machines are primarily located in major cities, making it difficult for patients in rural areas to receive timely access. Therefore, the importance of basic diagnostic methods like F.A.S.T. is even greater."
Impacts of Stroke on the Individual, Family, Community, and Nation
Stroke has devastating consequences that extend far beyond the patient to affect everyone connected to them.
1. Individual Impact
* Physical: Sudden one-sided weakness, paralysis, inability to walk, facial droop, leading to severe disability or death.
* Psychological: Depression, anxiety, isolation, and loss of self-confidence.
* Cognitive: Impairment in speech, understanding, and memory.
* Lifestyle Changes: Dependency on others for daily life and loss of employment.
2. Family Impact
* Caregiving Burden: A family member often must sacrifice their job, finances, and personal life to become a full-time caregiver.
* Financial Burden: Costs of long-term treatment, medication, and rehabilitation can rapidly deplete a family's economic stability.
* Psychological Strain: Increased stress, conflict, and depression among family members.
3. Societal Impact
* Strain on Healthcare System: The growing number of stroke patients places significant pressure and burden on hospitals, clinics, and healthcare providers.
* Loss of Productivity and Increased Need for Social Welfare Services.
4. National Impact
* National Economic Loss: High treatment costs and the loss of an active workforce negatively impact the Gross Domestic Product (GDP).
* Social Welfare Challenge: Increased burden on health insurance and social security systems, hindering development efforts.
Prevention and Control
Prevention is better than a cure. Controlling the risk factors can significantly reduce the chance of stroke.
(A) Individual Stroke Prevention
* Control Blood Pressure: Regularly check blood pressure and take prescribed medication consistently.
* Quit/Avoid Smoking: Stop using all tobacco products, including traditional cigarettes, vapes, and heated tobacco products.
* Maintain a Healthy Weight: Achieve and maintain a healthy body weight.
* Eat Healthily: Consume plenty of fruits, vegetables, and fibre; limit salt and high-fat foods.
* Exercise Regularly: Engage in at least 150 minutes of moderate exercise per week.
* Control Diabetes and Heart Disease: Manage these conditions systematically as instructed by a doctor.
(B) National-Level Control
* Public Awareness: Implement widespread educational campaigns to ensure the public knows the signs of stroke (F.A.S.T.) and how to respond in an emergency.
* Policy Implementation: Strictly enforce laws controlling tobacco (including e-cigarettes) and other unhealthy commodities.
* Enhance Healthcare: Expand and improve specialized stroke care units and rapid diagnostic/treatment services in both urban and rural areas.
Preventing stroke and ensuring rapid treatment is essential not only for saving individual lives but also for the economic and social stability of families and the nation.
Let all citizens strive to prevent stroke!
"Every Minute Counts!"
In the event of a stroke, time is the most critical element for treatment. This World Stroke Day, we urge everyone to:
* Know the Signs: Teach yourself, family, and friends the stroke warning signs (F.A.S.T.) until they are automatic.
* Act FAST: When in doubt, call for emergency help or transport the person to the hospital immediately.
* Start Preventing: Review your health and begin controlling the risk factors that can lead to stroke, starting today.
We strongly appeal to everyone to work together and unitedly to reduce the great burden posed by stroke.
References
* World Stroke Organization (WSO): WSD 2025 Campaign Toolkit. (Published: 2024)
* World Health Organization (WHO): Myanmar STEPS Survey 2019 Fact Sheet. (Published: 2020)
* Centres for Disease Control and Prevention (CDC): About Stroke (CDC Official Website). (Access Date: 2025)
* American Stroke Association: Stroke Risk Factors. (Access Date: 2025)
* World Health Organization (WHO): Cardiovascular diseases (CVDs). (Published: 2024)
* The Lancet Neurology: Global Burden of Stroke - Scientific Publications. (Various Years)
