Both types of stroke are on the rise in the Arab world. The World Health Organization estimates that in 2016 more than 326,000 people were killed by strokes in the Eastern Mediterranean region, which includes North Africa, the Middle East, Cyprus, Afghanistan and Pakistan. The number of people dying from strokes in the region jumped by over 30 percent between 2000 and 2016. (See a related article, “Patterns of Disease Are Changing in the Arab World.”)
That number is increasing partly because fewer people are dying from infectious diseases like cholera, which means they’re living long enough to die from a noncontagious cause like stroke. But it’s also true that risk factors associated with strokes are prevalent in the Arab world.
Pollution is one example. Najat Saliba, a professor of chemistry at the American University of Beirut, measured her city’s air pollution and asked a colleague in Los Angeles to do the same. (See a related article, “An Arab Researcher Seeks Solutions to Urban Pollution.”) “The results show Beirut has a major problem with pollution and it’s not even the worst in the Arab region,” she says. “That has major associated health concerns, such as cardiovascular problems like strokes.”
Additionally, high rates of smoking and obesity increase the risk of having a stroke.
Diagnosing a Stroke’s Severity
Khalaf is analyzing the way a stroke victim walks, looking for indicators of what she calls “gait deficit,” which include things like a shortened step, dropped toes or dragging feet. This metric would then be combined with the results of an electrocardiogram, which measures the heart’s electrical activity, and an electromyogram, which measures electrical activity in the body’s skeletal muscles.
“We’re trying to create an integrated way to help determine how bad the stroke was,” she explains. “There’s a small window after a stroke to rebuild the damaged neuropathways, and knowing the severity is key to that.”
In addition to helping diagnose the severity of a stroke, Khalaf will also follow patients through their recovery and rehabilitation to see how they progress, taking measurements throughout the process. She hopes this might highlight potential new insights into what hastens recovery, which could warrant further future research.
Other experts say that a novel approach like this is part of what’s needed to tackle the rising rates of noncommunicable diseases in the Arab world.
The other part is prevention, specifically convincing people to change unhealthy habits—but that’s easier said than done, according to Hanan Abdul Rahim, an associate professor of public health at Qatar University.
“You cannot ask people to change their behaviors and adopt healthy habits while continuing to live in the same environments that are conducive to smoking or overeating or being sedentary,” she says. That means introducing new legislation to regulate the tobacco industry and the marketing of unhealthy food—neither of which are easily achieved, she says.