Department of Internal Medicine, Faculty of Medicine and Health Sciences, University of Botswana, Gaborone, Botswana.
Trop Med Int Health. 2011 Jun;16(6):707-10. doi: 10.1111/j.1365-3156.2011.02759.x. Epub 2011 Mar 9.
Stroke is an increasing problem in sub-Saharan Africa, even in children. High rates of hypertension, diabetes, alcohol abuse, smoking, insufficient fruit and vegetable consumption, sickle cell disease, HIV infection, antiretroviral use and race are likely contributing factors. Although often considered as related to increasing wealth, stroke is more strongly related to poverty, and in turn increases it. Case-fatality rates are high and premature death and years of life lost are a major problem. We propose an approach to stroke prevention and treatment that takes into account the real situation on the ground and can be applied in sub-Saharan Africa, an area where stroke units are largely not feasible and many patients do not reach hospitals. Involvement of community and faith-based organisations, use of simple diagnostic tests, emphasis on clinical examination to differentiate between haemorrhagic and ischaemic stroke, prompt initiation of aspirin therapy and training of community nurses on essential management of stroke should be urgently implemented.
中风在撒哈拉以南非洲是一个日益严重的问题，甚至在儿童中也是如此。高血压、糖尿病、酗酒、吸烟、水果和蔬菜摄入不足、镰状细胞病、HIV 感染、抗逆转录病毒药物的使用和种族等因素可能是导致中风的原因。尽管中风通常被认为与财富的增加有关，但它与贫困的关系更为密切，反过来又会加剧贫困。中风的病死率很高，过早死亡和丧失的生命年数是一个主要问题。我们提出了一种预防和治疗中风的方法，该方法考虑到了当地的实际情况，适用于中风病房在很大程度上不可行且许多患者无法到达医院的撒哈拉以南非洲地区。应紧急实施社区和基于信仰的组织的参与、使用简单的诊断测试、强调临床检查以区分出血性和缺血性中风、迅速启动阿司匹林治疗以及对社区护士进行中风基本管理的培训。
