Owolabi M O
Department of Medicine, University College Hospital, PMB 5116, Ibadan, Nigeria, West Africa.
West Indian Med J. 2011 Jul;60(4):412-21.
Globally, stroke is the second leading cause of death. This is a systematic review of the existing literature to examine the burden and profile of stroke in the World Health Organization (WHO) African region and proffer coordinated and responsive means to tackle the epidemic.
A systematic review of the literature was conducted according to the Centre for Reviews and Dissemination Guidelines using Pubmed, African Journals On-Line and Google Scholar databases. Over 1300 articles were obtained. All abstracts were screened, and every article that might have contained relevant information was read in full. Their heterogeneity made meta-analysis impossible. So a critical assessment of the data with a narrative review was conducted.
Stroke has an annual incidence rate of up to 316 per 100 000, a prevalence rate of up to 315 per 100 000 and a three-year fatality of up to 84% in Africa. In 2002, model-based estimated age-adjusted stroke mortality rates ranged between 168 and 179 per 100 000 population for countries in the African region. There is severe scarcity of facilities and human resources for prevention, investigations, acute care and rehabilitation of stroke patients in Africa.
Africa bears a heavy burden of stroke. This author proposes a stroke quadrangle comprising a concerted network of four pillars: demographic surveillance and stroke research network, integrated community-based primary and secondary prevention programmes, easily accessible and well-equipped acute stroke care services, and neuro-rehabilitation centres and services. This network could be reinforced using information and communication technologies, telemedicine facilities and linked health information systems.
在全球范围内，中风是第二大致死原因。本文对现有文献进行系统综述，以研究世界卫生组织（WHO）非洲区域中风的负担和概况，并提出协调且有效的应对措施来应对这一流行病。
根据循证医学中心指南，利用PubMed、非洲在线期刊和谷歌学术数据库对文献进行系统综述。共获取1300多篇文章。对所有摘要进行筛选，并全文阅读每篇可能包含相关信息的文章。由于其异质性，无法进行荟萃分析。因此，对数据进行了批判性评估，并进行叙述性综述。
在非洲，中风的年发病率高达每10万人316例，患病率高达每10万人315例，三年死亡率高达84%。2002年，非洲区域各国基于模型估计的年龄标准化中风死亡率在每10万人口168至179例之间。非洲严重缺乏用于中风患者预防、检查、急性护理和康复的设施及人力资源。
非洲中风负担沉重。本文作者提议建立一个由四个支柱组成的中风四角框架：人口监测与中风研究网络、基于社区的综合初级和二级预防计划、易于获得且设备齐全的急性中风护理服务，以及神经康复中心和服务。可利用信息通信技术、远程医疗设施和相互关联的健康信息系统来加强这一网络。
