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

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.

Keywords: Africa; acute ischemic stroke; rehabilitation; stroke; stroke management.

Publication types

  • Review

MeSH terms

  • Africa / epidemiology
  • Fibrinolytic Agents
  • Humans
  • Ischemic Stroke*
  • Patient Care
  • Stroke* / diagnosis
  • Stroke* / epidemiology
  • Stroke* / therapy
  • Thrombolytic Therapy

Substances

  • Fibrinolytic Agents