Nigeria needs N100b yearly to treat stroke, says Pfizer Summit
IF NIGERIA must treat all stroke incidences in the country today, then an estimated sum of N100b ($500m by N200) will be required as hospital bill in private facilities.
The cost, it was gathered, will be a lot cheaper should government opt for public hospitals, paying an estimated sum of N11b ($55m) per year.
Though staggering on all fronts, experts, to show the public health burden of stroke already in the country, estimated the bill.
Fact is, the sick population in Nigeria still pays out-of-pocket for care. With seven out of every 10 Nigerian earning less than two-dollar a-day, cost of care is often unaffordable and ultimately leading to death. Unveiling the economic burden of stroke, therefore, reaffirms the cliché that “prevention is better than cure”.
Sharing some findings on economies of stroke incidences and treatments in the country, Professor of Medicine at the University of Ibadan, Adesola Ogunniyi noted that the burden of stroke was bigger than the public is currently aware.
Ogunniyi, at the opening of the eighth edition of cardiovascular summit, organised by Pfizer Nigeria, said while all Nigerians know someone that had either died or permanently disabled by the chronic disease, the cause is still more often than not attributed to spiritual forces — witches, wizards and other supernatural elements.
Ogunniyi, a consultant physician and neurologist at the University College Hospital (UCH), Ibadan, Oyo State, noted that stroke remains the number one cause of hospital admission in UCH and second leading cause of death in the world.
In the United States for instance, stroke accounts for one in every 20 deaths, even as the country records one stroke incident every 40 seconds.
Ogunniyi observed that a 1998 to 2000 study in Ibadan revealed 50.4 per cent prevalence rate. It was as high as 64.9 per cent in Enugu in a 2003 to 2007 study. Prof. Mustapha Danesi-led study in Surulere, Lagos, in 2007 finds 15 stroke incidences in 13,127-sample size (1.14 per 1000 population).
Among a tiny fraction of the population that may be aware of this epidemic rate, however, many don’t know how expensive the condition is until they have had a bout.
Ogunniyi reckons that because stroke is always a chronic disease, with attendant complications, the cost is the main challenge, both for the patients and the health system. At the back of his mind is over 70 per cent of Nigerian population that still pay out-of-pocket from meagre earnings.
In current realities, a minimum of six weeks of care in government-owned hospital (minus imagining) will cost N120, 000 ($600). Same duration will cost N1m ($5000) in a private hospital.
On attendant disease conditions associated with stroke, according to Ogunniyi, a bill of N6, 430 to N193, 000 goes with dementia treatment; N11, 337 per schizophrenia-related admission; Diabetes Mellitus will require N8, 571 per admission. Others are adult epilepsy, N43, 878 and N319, 200 for heart failure treatment in a year.
With the prevalence rate already pegged at 193,800 and an addition of about 91,800 new cases every year, it is therefore fairly easy to understand the attendant huge cost attached to the disease burden.
In the words of Ogunniyi, “Each year, about 90,000 new cases will be added on, based on incidence figure. It will therefore cost us $55m to look for stroke if they are managed in public hospital. But if it is private hospitals, it will cost half a billion dollars to look after stroke patients. That is just for one year. It may take about 11 years to have the patients fully recovered because of permanent disabilities,” he said.
The neurologist said they had noticed that Nigerians were changing lifestyles and becoming more westernized. In the process, they eat more saturated fats and become more sedentary with the computers and doing lesser physical exercises. There are lots of smoking and obesity too.
“Besides, the world is aging and Africa is not exempted. Between 1950 and 2050 there is significant increase in the percentage of people growing old; so aging is a factor. Second, stroke data from 22 countries, including Nigeria, show that hypertension is the number one risk factor. The other is smoking, obesity, poor diet, physical inactivity, diabetes and so on.
“As people get older the more stroke incidences and hypertension increase. Unfortunately, we cannot do anything about aging because it is important for people to get older. I have analysed seven stroke studies from different parts of the country looking at the proportion of individuals to stroke and hypertension. Again, we see that about 60 to 90 per cent of them are hypertensive when they have stroke. So, hypertension is a dominant risk factor. If hypertension prevalence increases, the problem of stroke increases too,” he said.