Stroke care in Africa: a systematic review of the literature

Urimubenshi, G. , Cadilhac, D. A., Kagwiza, J. N., Wu, O. and Langhorne, P. (2018) Stroke care in Africa: a systematic review of the literature. International Journal of Stroke, 13(8), pp. 797-805. (doi: 10.1177/1747493018772747) (PMID:29664359)

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Background: Appropriate systems of stroke care are important to manage the increasing death and disability associated with stroke in Africa. Information on existing stroke services in African countries is limited. Aim: To describe the status of stroke care in Africa. Summary of review: We undertook a systematic search of the published literature to identify recent (1 January 2006–20 June 2017) publications that described stroke care in any African country. Our initial search yielded 838 potential papers, of which 38 publications were eligible representing 14/54 African countries. Across the publications included for our review, the proportion of stroke patients reported to arrive at hospital within 3 h from stroke onset varied between 10% and 43%. The median time interval between stroke onset and hospital admission was 31 h. Poor awareness of stroke signs and symptoms, shortages of medical transportation, health care personnel, and stroke units, and the high cost of brain imaging, thrombolysis, and outpatient physiotherapy rehabilitation services were reported as major barriers to providing best-practice stroke care in Africa. Conclusions: This review provides an overview of stroke care in Africa, and highlights the paucity of available data. Stroke care in Africa usually fell below the recommended standards with variations across countries and settings. Combined efforts from policy makers and health care professionals in Africa are needed to improve, and ensure access, to organized stroke care in as many settings as possible. Mechanisms to routinely monitor usual care (i.e., registries or audits) are also needed to inform policy and practice.

Item Type:Articles
Additional Information:DAC holds a fellowship from the National Health and Medical Research Council (1063761 co-funded Heart Foundation).
Glasgow Author(s) Enlighten ID:Urimubenshi, Gerard and Langhorne, Professor Peter and Wu, Professor Olivia
Authors: Urimubenshi, G., Cadilhac, D. A., Kagwiza, J. N., Wu, O., and Langhorne, P.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment
Journal Name:International Journal of Stroke
Publisher:SAGE Publications
ISSN (Online):1747-4949
Published Online:17 April 2018
Copyright Holders:Copyright © 2018 World Stroke Organization
First Published:First published in International Journal of Stroke 13(8): 797-805
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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