Contribution of neuro NCDs to India's disease burden more than doubled from 1990-2009

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

The first comprehensive estimates of disease burden due to neurological disorders and their trends in every state of India from 1990 was published on Wednesday in The Lancet Global Health by the India State-Level Disease Burden Initiative.

According to the findings, the burden of non-communicable neurological disorders is increasing in India mainly due to the ageing of the population. While communicable diseases contributed to the majority of total neurological disorders burden in children younger than 5 years, non-communicable neurological disorders were the biggest contributor in all other age groups, the Indian Council of Medical Research (ICMR) said in a release.

Strokes, headache disorders and epilepsy are the leading contributors to neurological disorders burden in India, it said.

In 2019, strokes caused 6,99,000 deaths, which was 7.4 per cent of the total deaths in the country. The burden of many neurological disorders varied considerably between the states, which has significant implications for the policies and programmes to reduce this burden, it stated.

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

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

The state-specific findings described in this scientific paper highlight the extent of the 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 trends over about three decades reported in this research paper utilised all available data sources from India that enabled more robust estimates of neurological disorder burden across India than those available so far.

Dr Vinod Paul, Member (Health) NITI Aayog said this scientific paper presents a comprehensive perspective of the burden of neurological disorders over the last 30 years and systematically highlights the variations between the states.

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

"There is a need to address the shortage of trained neurology workforce and strengthen early detection and cost-effective management of neurological disorders in the country to deal with their growing burden," he said.

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

"Neurological disorders contribute 10 per cent of the total disease burden in India. There is a growing burden of non-communicable neurological disorders in the country, which is mainly attributable to ageing of the population," he said.

Prof Gagandeep Singh of Dayanand Medical College and the first author of the paper said the analysis in this paper highlights the key issues related to trends of neurological disorders in the states of India.

Epilepsy is a common neurological disorder in India. While the prevalence of epilepsy has increased over the past three decades, it is gratifying to note that India has made some gains in reducing premature deaths and morbidity of people with epilepsy over this period by reducing treatment gaps. There is, however, a need to scale up treatment coverage of epilepsy in governmental schemes such as the Rashtriya Bal Swasthya Karyakram and Ayushman Bharat, he said.

Policies and practices focusing on safe births, preventing head injury and stroke would help in averting a substantial proportion of epilepsies, he added.

Professor K Srinath Reddy, president of Public Health Foundation of India, said the rise of non-communicable disease (NCD) related risk factors as the leading contributor to neurological disorders and resultant disability in India is not a surprise.

It reflects the demographic, socio-economic and nutrition transitions that have steered the shift in our epidemiological profile over the past 30 years. What is helpful is the recognition that much of this burden of disease and disability is related to modifiable risk factors which can be reduced at the population level and corrected at the individual level.