Abstract:
Background and objective:
Ischemic stroke still poses a significant health concern throughout the world. However, low and middle-income
countries (LMIC) in Asia have more devastating outcome. The vascular risk factors are prevalent in most parts of Asia,
contributing to increasing incidence. The recommended approved treatment for acute stroke is limited to a few areas
in these countries. We aimed to identify stroke risk factors, its incidence and prevalence; treatment opportunities
offered in various parts of the region and utilizing the alternate pathways to improve the disease recognition and
management outcome.
Method:
A comprehensive search using PubMed, MEDLINE, Medline Plus, PubMed Central and Pak Medinet, including the
various key words was performed,
Results:
Two-hundred-fifty-five articles of potential interest were found through the initial search. The studies were analyzed in
detail in order to obtain relevant information according to the objectives of the review. Most of the literature was
regarding the stroke risk factors. Only few articles regarding the current status of stroke services and management
options in LMIC were available.
Conclusion:
Some of the factors identified in previous studies preventing the utilization of recent advancement in the diagnosis and
management of stroke in LMIC, including Pakistan, were lack of awareness of stroke symptoms among general
population and physicians, poor knowledge of management options, unavailability of trained stroke neurologists, poor
infrastructure, cost effectiveness and patients’ trust more on homeopathic physicians, quacks and spiritual healers
instead of medical doctors. Stroke is still managed conservatively in most part of these countries. There is strong need
of alternate means to overcome these shortcomings in managing this highly morbid condition. As only few studies
specifying the prevalence and management outcome in LMIC including Pakistan are available, a strong database is
needed to quantify the real burden.
Page(s):
48-57
DOI:
DOI not available
Published:
Journal: Pakistan Journal of Neurological Sciences, Volume: 17, Issue: 4, Year: 2022
Keywords:
Pakistan
,
Management
,
Low and middleincome countries
,
Stroke
,
Telestroke