The contribution of neuro NCDs to the disease burden in India more than doubled between 1990 and 2009

The contribution of non-communicable and injury-related diseases neurological disorders the total burden of disease more than doubled in India from 1990 to 2019, while that of communicable neurological disorders fell by three quarters, according to the findings of the India State Burden of Disease Initiative.

The first comprehensive estimates of the burden of disease from neurological disorders and their trends in each state in India from 1990 onwards were published Wednesday in The Lancet Global Health by India’s State Burden of Disease Initiative.

According to the results, the load of non-communicable neurological disorders increasing in India mainly due to the aging of the population. While communicable diseases contributed the majority of the total burden of neurological disorders in children under 5 years of age, non-communicable neurological disorders were the main contributor in all other age groups, the Indian Council of Medical Research (ICMR) said in a statement.

Stroke, headache and epilepsy are the main contributors to the burden of neurological disorders in India, he said.

In 2019, stroke caused 699,000 deaths, or 7.4% of total deaths in the country. The burden of many neurological disorders varied widely between states, which has important implications for policies and programs aimed at reducing this burden, he said.

Among the known risk factors for the burden of neurological disorders, high blood pressure, air pollution, dietary risks, high fasting blood sugar and high body mass index are the main contributors.

The study was carried out by the Indian State Burden of Disease Initiative, a collaborative effort between ICMR, the Public Health Foundation of India, the Institute for Health Metrics and Evaluation, and a a number of other key stakeholders in India, including academic experts and institutions, government agencies and other organizations, under the aegis of the Ministry of Health.

The state-specific findings described in this scientific article highlight the extent of effort needed in each state to reduce the burden of neurological disorders through state-specific health system responses aimed at increasing awareness, early identification, cost-effective treatment and rehabilitation.

The roughly three-decade trends reported in this research paper used all available data sources in India which allowed more robust estimates of the burden of neurological disorders in India than those available so far.

NITI Aayog (health) member Dr Vinod Paul said this scientific article presents a holistic perspective on the burden of neurological disorders over the past 30 years and consistently highlights variations between states.

Several government policies and initiatives are in place to address the burden of neurological disorders across India, however, more targeted efforts are needed for the planning of specific neurology services in each state, he said.

“There is a need to address the shortage of qualified personnel in neurology and to strengthen the early detection and cost-effective management of neurological disorders in the country to cope with their growing burden,” he said.

Dr Balram Bhargava, secretary of the Department of Health Research, Ministry of Health and director general of ICMR, said this research paper provides the first consolidated estimates of the burden of most neurological disorders for each state. India from 1990 to 2019.

“Neurological disorders represent 10% of the total disease burden in India. There is a growing burden of noncommunicable neurological disorders in the country, which is mainly attributable to the aging of the population, ”he said.

Professor Gagandeep Singh of Dayanand Medical College and first author of the article said that the analysis of this article highlights key issues related to trends in neurological disorders in Indian states.

Epilepsy is a common neurological disorder in India. While the prevalence of epilepsy has increased over the past three decades, it is encouraging to note that India has made progress in reducing premature deaths and morbidity among people with epilepsy during this period by reducing treatment differences. However, there is a need to expand the coverage of epilepsy treatment in government programs such as Rashtriya Bal Swasthya Karyakram and Ayushman Bharat, he said.

Policies and practices focused on safe deliveries, prevention of head injuries and strokes would help prevent a substantial proportion of epilepsies, he added.

Professor K Srinath Reddy, Chairman of the Public Health Foundation of India, said that the increase in risk factors for noncommunicable diseases (NCDs) as the main contributor to neurological disorders and the resulting disability in India is no surprise.

It reflects the demographic, socio-economic and nutritional transitions that have guided the evolution of our epidemiological profile over the past 30 years. What is useful is to recognize that much of this burden of disease and disability is linked to modifiable risk factors that can be reduced at the population level and corrected at the individual level.