Accessibility to rt-PA in Sub-Saharan Africa, Congolese stroke unit experience: Call for an urgent action

Ossou-Nguıet, Paul Macaire; Otiobanda, Gilbert Fabrice; Mawandza, P D G; Ikama, Méo Stéphane; Mbolla, Bertrand Fikahem Ellenga; Ondze-Kafata, Louis Igor; Bandzouzi-Ndamba, Bébène

doi:10.1177/1747493015616642

Cited by 7 publications

(19 citation statements)

References 2 publications

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“…Similar to other resource‐poor regions, recent research indicates access and delivery of quality and evidence‐based stroke care in Africa is limited and often poor . Studies in Ghana, Senegal and Congo further exemplify the limited nature of access to quality and evidence‐based stroke care in LMICs. Efforts to improve uptake of better stroke care interventions to ensure optimal patient outcomes in resource‐poor settings have been persistently hampered by a range of barriers such as lack of skilled health personnel, patients’ lack of funds to meet health‐care costs and inadequate health infrastructure .…”

Section: Introductionmentioning

confidence: 95%

“…Within the context of stroke care, a paradoxical situation exists where delivery of quality and evidence‐based care for optimal patient outcomes is relatively limited and poor in LMICs compared to high‐income countries (HICs), although about 80% of the entire global burden of stroke is reported from LMICs . This burden has been largely attributed to the poor quality of care delivered in those settings and the low uptake of evidence‐based practice . Findings from the recent INTERSTROKE study further underscore the poor and limited access to optimal stroke care, leading to poor patient outcomes in LMICs …”

Section: Introductionmentioning

confidence: 99%

“…3 This burden has been largely attributed to the poor quality of care delivered in those settings and the low uptake of evidence-based practice. [4][5][6][7] Findings from the recent INTERSTROKE study further underscore the poor and limited access to optimal stroke care, leading to poor patient outcomes in LMICs. 8 Similar to other resource-poor regions, recent research indicates access and delivery of quality and evidence-based stroke care in Africa is limited and often poor.…”

Section: Introductionmentioning

confidence: 99%

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Improving the quality of care for people who had a stroke in a low‐/middle‐income country: A qualitative analysis of health‐care professionals’ perspectives

Baatiema

Aikins

Abimbola

et al. 2020

Health Expectations

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Background and Objective Efforts to improve the adoption of evidence‐based interventions for optimal patient outcomes in low‐/middle‐income countries (LMICs) are persistently hampered by a plethora of barriers. Yet, little is known about strategies to address such barriers to improve quality stroke care. This study seeks to explore health professionals’ views on strategies to improve quality stroke care for people who had a stroke in a LMIC. Methods A qualitative interview study design was adopted. A semi‐structured interview guide was used to conduct in‐depth interviews among forty stroke care providers in major referral centres in Ghana. Participants were from nursing, medical, specialist and allied health professional groups. A purposive sample was recruited to share their views on practical strategies to improve quality stroke care in clinical settings. A thematic analysis approach was utilized to inductively analyse the data. Results A number of overarching themes of strategies to improve quality stroke care were identified: computerization and digitization of medical practice, allocation of adequate resources, increase the human resource capacity to deliver stroke care, development of clinical guideline/treatment protocols, institutionalization of multidisciplinary care and professional development opportunities. These strategies were however differentially prioritized among different categories of stroke care providers. Conclusion Closing the gap between existing knowledge on how to improve quality of stroke care in LMICs has the potential to be successful if unique and context‐specific measures from the views of stroke care providers are considered in developing quality improvement strategies and health systems and policy reforms. However, for optimal outcomes, further research into the effectiveness and feasibility of the proposed strategies by stroke care providers is needed.

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Section: Introductionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Improving the quality of care for people who had a stroke in a low‐/middle‐income country: A qualitative analysis of health‐care professionals’ perspectives

Baatiema

Aikins

Abimbola

et al. 2020

Health Expectations

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“…Only a few cases are reported. This is due to several factors: the lack of trained human resources in vascular neurology, the absence of neurovascular units and the high cost of rt-PA [6]. Current case is the second thrombolysis in Congo.…”

Section: Case Presentationmentioning

confidence: 99%

“…In our series, just 5.6% of patients admitted for ischemic stroke where eligible. They not benefit from IV thrombolysis due to the high cost of rt-PA [6]. Before this case, just one IV thrombolysis was performed.…”

Section: Introductionmentioning

confidence: 99%

Stroke in Sub-Saharan Africa, from Thrombolysis to Decompressive Craniectomy: Case Report

Pm¹

2017

Austin J Cerebrovasc Dis & Stroke

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The management of ischemic stroke is currently adapted in stroke unit. IV thrombolysis and mechanical thrombectomy are the most effectiveness treatments.We report the case of 54-year-old patient, who was admitted in our department for sudden left hemiparesis. According to initial examination and CTscan, he needs treatment by IV thrombolysis and mechanical thrombectomy, but in Congo mechanical thrombectomy is not available. He has IV thrombolysis alone, without success. The control CT-scan showed malignant infarction for which thrombectomy was not indicated. The patient died 24 hours after.

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Stroke Care and Mechanical Thrombectomy in Developing Countries

Roa

Martins

Mont’alverne

2019

Acute Stroke Management in the Era of Thrombectomy

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Accessibility to rt-PA in Sub-Saharan Africa, Congolese stroke unit experience: Call for an urgent action

Cited by 7 publications

References 2 publications

Improving the quality of care for people who had a stroke in a low‐/middle‐income country: A qualitative analysis of health‐care professionals’ perspectives

Improving the quality of care for people who had a stroke in a low‐/middle‐income country: A qualitative analysis of health‐care professionals’ perspectives

Stroke in Sub-Saharan Africa, from Thrombolysis to Decompressive Craniectomy: Case Report

Stroke Care and Mechanical Thrombectomy in Developing Countries

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