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非洲急性缺血性中风的当前管理:文献综述

Current management of acute ischemic stroke in Africa: A review of the literature.

作者信息

Uwishema Olivier, Berjaoui Christin, Correia Inês F Silva, Anis Heeba, Karabulut Ece, Essayli Dina, Mhanna Melissa, Oluyemisi Adekunbi

机构信息

Oli Health Magazine Organization, Research and Education, Kigali, Rwanda.

Clinton Global Initiative University, New York, New York, USA.

出版信息

Eur J Neurol. 2022 Nov;29(11):3460-3465. doi: 10.1111/ene.15495. Epub 2022 Jul 26.

Abstract

BACKGROUND AND PURPOSE

Acute ischemic stroke is one of the leading causes of disability and mortality globally, with increasing incidence in Africa, as the continent is already burdened with infectious diseases. Rapid diagnosis and efficient treatment are crucial, as even a slight delay in reperfusing the brain significantly affects the recovery outcome. Neuroimaging is vital for optimal care and thrombolytic or endovascular therapy in specialized stroke care units. This review aims to discuss the burden of acute ischemic stroke in Africa and how health care systems have tried to reduce the incidence and improve outcomes for the disease.

METHODS

Data were collected through the online databases PubMed, Ovid MEDLINE, ScienceDirect, and Embase. All articles related to acute ischemic stroke in Africa were considered.

RESULTS

The medical care for acute ischemic stroke in Africa is far from optimal, with little adherence to recommended protocols. There is a lack of public awareness of the disease, imaging infrastructure, personnel, stroke care units, and recovery facilities due to poor funding. Poor knowledge of stroke signs and symptoms results in delay in treatment and poor prognosis.

CONCLUSIONS

We urge African leaders and private entities to invest in stroke care by building appropriate infrastructures, providing medical equipment, and implementing guidelines and sustainable follow-up systems. Telehealth is a suggested strategy to mitigate the scarcity of health personnel, and international and national efforts to increase treatment affordability should be doubled. Further extensive research on the impact of acute ischemic stroke on the African population is encouraged.

摘要

背景与目的

急性缺血性卒中是全球致残和致死的主要原因之一,在非洲其发病率不断上升,因为该大陆已饱受传染病困扰。快速诊断和有效治疗至关重要,因为即使脑部再灌注稍有延迟也会显著影响恢复结果。神经影像学对于专科卒中治疗单元的最佳治疗及溶栓或血管内治疗至关重要。本综述旨在探讨非洲急性缺血性卒中的负担,以及医疗保健系统如何试图降低该疾病的发病率并改善其治疗结果。

方法

通过在线数据库PubMed、Ovid MEDLINE、ScienceDirect和Embase收集数据。纳入所有与非洲急性缺血性卒中相关的文章。

结果

非洲急性缺血性卒中的医疗护理远未达到最佳水平,对推荐方案的遵循程度很低。由于资金不足,公众对该疾病、影像基础设施、人员、卒中治疗单元及康复设施缺乏了解。对卒中体征和症状的认识不足导致治疗延迟和预后不良。

结论

我们敦促非洲领导人及私人实体通过建设适当的基础设施、提供医疗设备以及实施指南和可持续的随访系统来投资卒中护理。远程医疗是缓解卫生人员短缺的一项建议策略,并且应加倍努力在国际和国家层面提高治疗的可及性。鼓励对急性缺血性卒中对非洲人群的影响进行进一步广泛研究。

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