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Door-to-door survey on strokes

Sep 17, 2013

A DOOR-to-door survey is scheduled to start this Saturday to obtain important information on strokes and other neurological diseases in Brunei Darussalam. This survey is touted as the first of its kind in the region with the results of the study expected to attract international attention.

The survey which will incorporate questionnaires and simple physical examination is a fundamental component of a research that aims to get to the heart of how strokes affect the population and the causes in an effort to enhance the health of the people in Brunei Darussalam, Professor Datin Seri Laila Jasa Dr Uta Meyding-Lamade said at a press conference at the Jerudong Park Medical Centre (JPMC) yesterday. She is the Executive Director of the Brunei Neuroscience Stroke Rehabilitation Centre (BNSRC) and Consultant Neurologist at the JPMC.

The survey, she said, is the culmination of a pilot study that had been conducted and the first stage of the Brunei Epidemiology of Stroke and Multiple Sclerosis (BEST) study is the survey that should take weeks to complete.

Well-trained interviewers will conduct visits to randomly selected homes and pose questions to the occupants who are 18 years old and above. Health examinations will also be carried out.

Armed with the knowledge of telescience training, the interviewers will help in the compilation of data on the frequency of strokes and other neurological diseases.

This will be a milestone in stroke studies in the region with prime objectives in the determination of the prevalence, the incidence and the mortality rate of strokes, and the distribution of stroke risk factors in the population, Professor Datin Seri Laila Jasa Dr Uta Meyding-Lamade said.

Data collected from the survey will be crucial in adapting treatment methods and rehabilitation facilities in the country.

She revealed preliminary results showed that Brunei stroke victims were younger than their European counterparts.

"The project will enhance the awareness and knowledge of the risk factors and actions to be taken when stroke symptoms appear."

Initial studies and preliminary data have been presented to international conferences (eg: the 23rd Meeting of the European Neurological Society 2013; Asian Pacific 2012; American Academy of Neurology 2012; the World Stroke Congress 2012; and the European Stroke Congress 2012), with four publications printed since the set-up of the project.

She said the project study could be the first in the world.

On why Brunei stroke victims were younger than European victims, she said the study should be able to ascertain the reason and the relevant preventive and health measures that could be adopted.

She said that in Germany, victims would be treated immediately, whereas in Brunei, "it can take two weeks before the patient is warded".

"The survey and the overall project research will assist in finding out the cause of this disparity," she added.

She said the survey results should be out in a year and that the total project would last up to three years.

She added that eight research officers – distinguishable with wearing designated shirts and relevant identification tags – would be involved in the house-to-house survey.

On the selection process of participants to be interviewed, UBD's Agong Lupat said the head of villages would be informed of the selection of households, and leaflets or letters would be sent to the selected homes.

"Hopefully, the community will cooperate as the survey will provide a greater understanding of the disease," he added.

Agong Lupat said data from the survey would be compiled to form a database and be used for possible publication.

The areas selected for the survey include several mukims and kampongs such as Kianggeh, Sg Kedayan, Saba, Burong Pingai Ayer, Berakas A, Berakas B, Gadong A, Gadong B, Kota Batu, Lumapas, Kilanas, Sengkurong, Pengkalan Batu, Mentiri, Serasa, Peramu and Tamoi.

This transcontinental research project involves Universiti Brunei Darussalam (UBD), University of Heidelberg, Germany, Jerudong Park Medical Centre (JPMC) and Krankenhaus Nordwest, Frankfurt, Germany.

From UBD, the scientists participating are Agong Lupat, Dr Hashmet Parveen, Masliza Liussin, Dr Suwarni Diah and Dr Hanna Muharram.

The scientists from BNSRC are Dr Amri Masri, Dr Chan Guan Choon, Dr Dk Hjh Norazieda Pg Hj Yassin, Professor Datin Dr Uta Meyding-Lamade, and with a host of other eminent scientists from the University of Heidelberg and Krankenhaus Nordwest that include Dr Yashar Aghazadeh, Dr Fazean Irdayati Hj Idris, Norshahzuani Azaman, Dr Christian Jacobi, Burc Bassa, Eva Craemer, Professor Bodo Kress and Dr Thorsten Lenhard, Dr Francisco Martinez-Torres, Marc Grosserueschkamp, Anna Steinmann, Felicitas Bunke, Jana Jlidi, Liane Muller-Herfort, Mario Fix and Professor Heiko Becher.

This collaboration also involves six Discovery Year students from UBD who had visited Krankenhaus Nordwest, Frankfurt and University of Heidelberg, Otto-Meyerhof Centre. The next Discovery Year visit is due this month with one student to spend a year in Germany.

During the three-month stint, the former Discovery Year students contributed to three scientific papers.

Students also presented posters during the 2nd Neurological Conference in Brunei in November last year.

Datin Dr Uta Meyding-Lamade, who is also the head of a clinical trial centre and laboratory scientific group in Heidelberg, welcomed the Bruneian students to join the research team.

The Brunei Neuroscience Stroke Rehabilitation Centre was established in response to His Majesty the Sultan and Yang Di-Pertuan of Brunei Darussalam's vision to enhance the health and well-being of the people as well as having a world-class​​ health centre in the country.

The Government of His Majesty has identified stroke as a major health problem in the country, a disease which is the second most common cause of death in the world and the leading cause of permanent disability.

The project includes the setting-up of a database of patients treated in BNSRC at JPMC.

Further work is also conducted on a laboratory project that measures the function of thrombocytes in stroke and inflammatory diseases and a dementia project that looks for a typical pattern in MRI, thus making the early detection of dementia possible.​

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