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Implementing Evidence-Based Practices for Acute Stroke Care in Low- and Middle-Income Countries

  • Cardiovascular Disease and Stroke (Shyam Prabhakaran, Section Editor)
  • Published:
Current Atherosclerosis Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Most strokes occur in low- and middle-income countries where resources to manage patients are limited. We explore the resources required to providing optimal acute stroke care and review barriers to implementing evidence-based stroke care in settings with limited resources using the World Stroke Organization’s Global Stroke Services Action Plan framework.

Recent Findings

Major advances have been made during the past few decades in stroke prevention, treatment, and rehabilitation. These advances have been translated into practice in many high-income countries, but their uptake remains suboptimal in low- and middle-income countries.

Summary

The review highlights the resources required to providing optimal acute stroke care in settings with limited resources. These resource levels were divided into minimal, essential, and advanced resources depending on the availability of stroke expertise, diagnostics, and facilities. Resources were described for the three stages of acute care: early diagnosis and management, acute management and prevention of complications, and early discharge and rehabilitation. Barriers to providing acute care at each of these stages in low- and middle-income countries are reviewed, explaining that some barriers persist in essential or advanced settings where some aspects of organized stroke units are available.

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Author information

Authors and Affiliations

  1. Departments of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Rasha Khatib & Yurany A. Arevalo

  2. Department of General Surgery, Palestine Medical Complex, Ramallah, Palestine

    Assef M. Jawaada

  3. Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Ramallah, Palestine

    Assef M. Jawaada

  4. Department of Internal Medicine, Palestine Medical Complex, Ramallah, Palestine

    Hiba K. Hamed & Sukayna H. Mohammed

  5. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Drive, Suite1400, Chicago, IL, USA

    Mark D. Huffman

Authors
  1. Rasha Khatib
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  2. Assef M. Jawaada
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  3. Yurany A. Arevalo
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  4. Hiba K. Hamed
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  6. Mark D. Huffman
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Corresponding author

Correspondence to Mark D. Huffman.

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Conflict of Interest

MDH receives grant support from the World Heart Federation to serve as senior program advisor for its Emerging Leaders program. The program is sponsored by unrestricted educational grants from Boehringer Ingelheim and Novartis with previous support from BUPA and AstraZeneca. RK, AMJ, YAA, HKM, and SHM declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Cardiovascular Disease and Stroke

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Khatib, R., Jawaada, A.M., Arevalo, Y.A. et al. Implementing Evidence-Based Practices for Acute Stroke Care in Low- and Middle-Income Countries. Curr Atheroscler Rep 19, 61 (2017). https://doi.org/10.1007/s11883-017-0694-6

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  • DOI: https://doi.org/10.1007/s11883-017-0694-6

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