Wiyarta Elvan, Fisher Marc, Kurniawan Mohammad, Hidayat Rakhmad, Geraldi Iskandar Purba, Khan Qaisar Ali, Widyadharma I Putu Eka, Badshah Aliena, Pandian Jeyaraj Durai
Department of Neurology, Faculty of Medicine, Universitas Indonesia-Dr. Cipto Mangunkusumo National Hospital, Central Jakarta, Jakarta 10430, Indonesia.
Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
J Clin Med. 2024 Aug 14;13(16):4780. doi: 10.3390/jcm13164780.
Stroke is a leading cause of disability and mortality worldwide, and it disproportionately affects low- and middle-income countries (LMICs), which account for 88% of stroke fatalities. Prehospital stroke care delays are a crucial obstacle to successful treatment in these settings, especially given the limited therapeutic window for thrombolytic treatments, which may greatly improve recovery chances when initiated early after stroke onset. These delays are caused by a lack of public understanding of stroke symptoms, sociodemographic and cultural variables, and insufficient healthcare infrastructure. This review discusses these issues in detail, emphasizing the disparities in stroke awareness and reaction times between locations and socioeconomic classes. Innovative options for reducing these delays include the deployment of mobile stroke units and community-based educational campaigns. This review also discusses how technology improvements and personalized educational initiatives might improve stroke awareness and response in LMICs. The primary goal is to give a thorough assessment of the challenges and potential remedies that might serve as the foundation for policy reforms and healthcare improvements in LMICs, eventually improving stroke care and lowering disease-related mortality and disability.
中风是全球残疾和死亡的主要原因,对低收入和中等收入国家(LMICs)的影响尤为严重,这些国家占中风死亡人数的88%。院前中风护理延误是这些地区成功治疗的关键障碍,特别是考虑到溶栓治疗的治疗窗口有限,中风发作后尽早开始溶栓治疗可能会大大提高康复几率。这些延误是由于公众对中风症状、社会人口统计学和文化变量缺乏了解,以及医疗保健基础设施不足造成的。本综述详细讨论了这些问题,强调了不同地点和社会经济阶层在中风意识和反应时间方面的差异。减少这些延误的创新选择包括部署移动中风单元和开展社区教育活动。本综述还讨论了技术进步和个性化教育举措如何提高低收入和中等收入国家的中风意识和反应能力。主要目标是全面评估这些挑战和潜在的补救措施,为低收入和中等收入国家的政策改革和医疗保健改善奠定基础,最终改善中风护理,降低与疾病相关的死亡率和残疾率。