Stroke cases on the rise in Brunei

James Kon

Stroke was the fourth highest cause of death in Brunei Darussalam in 2019, with 162 fatalities. Since 2015, this number has gone up by 60, while up to 400 new cases of stroke are annually recorded in the country.

This was highlighted by Director of the Brunei Neuroscience Stroke and Rehabilitation Centre at the Pantai Jerudong Specialist Centre (PJSC) Pengiran Dr Hajah Siti Nur’Ashikin binti Pengiran Dato Paduka Haji Tengah during a World Stroke Day event hosted by the PJSC.

She said, “Stroke is not only devastating because of the loss of lives. The impact of disability caused by a stroke affects a person’s livelihood, their family and their community.”

“While we hope and pray that people recover from stroke; the reality is that the most stroke sufferers have permanent disabilities. Stroke is the number one cause of disability worldwide and in Brunei Darussalam.

“Over the past two years, the Brunei Neuroscience Stroke and Rehabilitation Centre has conducted several studies to better understand the occurrence of stroke in Brunei Darussalam. From these studies, it is gratifying to see that our patients are able to receive the latest medical treatment and that our outcomes for stroke treatment are comparable to developed countries.”

She added, “Our patients are able to receive clot-busting treatment known as thrombolysis, and our centre has started to offer thrombectomy, a treatment to suck out blood clots from blocked blood vessels.”

Minister of Health Dato Seri Setia Dr Haji Mohd Isham bin Haji Jaafar, Minister at the Prime Minister’s Office and Minister of Finance and Economy II Dato Seri Setia Dr Awang Haji Mohd Amin Liew bin Abdullah and Minister of Culture, Youth and Sports Major General (Rtd) Dato Paduka Seri Haji Aminuddin Ihsan bin Pehin Orang Kaya Saiful Mulok Dato Seri Paduka Haji Abidin during the World Stroke Day event at Pantai Jerudong Specialist Centre. PHOTO: JAMES KON

“Our rehabilitation ward and rehabilitation department have motivated and treated many patients to meaningful recovery.

“However, these studies also highlight where we can do better. Our studies show that the mean age of having a stroke in Brunei Darussalam is at 51 years compared to 63 in Korea and 68 in the United States (US). Is it genetics? Is it culture? Is it behaviour? More research is needed on the social economic determinants of health in this country.

“Studies also show that 65 of stroke patients are under the age of 60. More than half of patients have multiple risk factors, which recently have included a worrying trend for illicit drug use.

“Despite available treatments, we have found that many people come to the hospital too late to receive effective therapies such as thrombolysis. One study showed that only 13 per cent of patients arrived to hospital within the crucial four-and-a-half hour time window to receive thrombolysis, while other studies have shown delays are due to limited knowledge of stroke.

“We need to continue awareness campaigns to encourage health-seeking behaviour, especially in acute stroke, so that patients come to the hospital on time. Our medical social work department has also shown the increased needs of stroke survivors, underscoring the importance of supporting them and their carers.

“The Ministry of Health (MoH) has taken a firm stance on NCDs through a national multi-sectorial action plan, and over the past few years, physical activity has improved by 10 per cent. Initiatives led by the Physical Activity team at the Ministry of Health’s Health Promotion Centre have included the workplace and health programmes, and the happy environment and lifestyle programme.

“Other national action plans such as from the Ministry of Culture, Youth and Sports target activity among youth and within health ageing.

“All adults should be encouraged to be more physically active within safe limits. This could include taking the stairs instead of the lift, being more physically active at home and in the garden, and walking more regularly throughout the day.”

Minister of Health Dato Seri Setia Dr Haji Mohd Isham bin Haji Jaafar, Minister at the Prime Minister’s Office and Minister of Finance and Economy II Dato Seri Setia Dr Awang Haji Mohd Amin Liew bin Abdullah, and Minister of Culture, Youth and Sports Major General (Rtd) Dato Paduka Seri Haji Aminuddin Ihsan bin Pehin Orang Kaya Saiful Mulok Dato Seri Paduka Haji Abidin were also present.