Stroke Management in Developing Countries

Abstract

Stroke remains a global leading cause of morbidity and mortality. It has immense burden on public health in both developed and developing countries with substantial economic cost of treatment and rehabilitation as well as social consequences. However, developing countries lack data, resources, policies, and structures to adequately face its burden. Generally, stroke can be ischemic or hemorrhagic with a higher prevalence of the ischemic subtype. Treatment in the acute phase usually relies on the administration of alteplase or reperfusion therapy and rehabilitation should be initialized soon after. Early arrival to hospital, rapid imaging, and diagnosis as well as availability of specialized staff are all essential to reperfusion therapy. Development of stroke units and treatment protocols is therefore recommended to achieve higher thrombolysis rates and better outcomes. Primary and secondary preventions are also high priority to limit stroke burden particularly hypertension control where access to medications and public awareness play a crucial role. Many challenges to treatment and prevention exist among developing countries with inconsistencies between low-income and middle-income countries and between rural and urban areas. Urgent interventions are needed and more research is required to establish quality data and help set priorities.