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3. Pragmatic solutions to reduce the global burden of stroke: a World Stroke Organization–Lancet Neurology Commission

Author

Feigin, V, Owolabi, M, Abd-Allah, F, Akinyemi, R, Bhattacharjee, N, Brainin, M, Cao, J, Caso, V, Dalton, B, Davis, A, Dempsey, R, Duprey, J, Feng, W, Ford, G, Gall, S, Gandhi, D, Good, D, Hachinski, V, Hacke, W, Hankey, G, Ishida, M, Johnson, W, Kim, J, Lavados, P, Lindsay, P, Mahal, A, Martins, S, Murray, C, Nguyen, T, Norrving, B, Olaiya, M, Olalusi, O, Pandian, J, Phan, H, Platz, T, Ranta, A, Rehman, S, Roth, G, Sebastian, I, Smith, A, Suwanwela, N, Sylaja, P, Thapa, R, Thrift, A, Uvere, E, Vollset, S, Yavagal, D, Yaria, J, Abera, S, Ibrahim, N, Liu, L, Ovbiagele, B, Piradov, M, Abanto, C, Addissie, A, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar de Sousa, D, Akhmetzhanova, Z, Akpalu, A, El Alaoui-Faris, M, Ameriso, S, Andonova, S, Arsovska, A, Awoniyi, F, Bakhiet, M, Barboza, M, Basri, H, Bath, P, Bereczki, D, Beretta, S, Berkowitz, A, Bernhardt, J, Berzina, G, Bhavsar, B, Bisharyan, M, Bohara, M, Bovet, P, Budincevic, H, Cadilhac, D, Cerimagic, D, Charway-Felli, A, Chen, C, Chin, J, Christensen, H, Chwojnicki, K, Conforto, A, Correia, M, Mora Cuervo, D, Czlonkowska, A, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Demchuk, A, Dichgans, M, Dokova, K, Donnan, G, Duran, J, Ekeng, G, Elkind, M, Endres, M, Fischer, U, Flomin, Y, Gankpe, F, Gavidia, M, Gaye Saavedra, A, Gebreyohanns, M, George, M, Gierlotka, M, Giroud, M, Gnedovskaya, E, Goncalves, I, Gongora-Rivera, F, Gunaratne, P, Hamadeh, R, Hamzat, T, Heldner, M, Ibrahim, E, Ihle-Hansen, H, Jee, S, Jiann-Shing, J, Johnston, S, Jovanovic, D, Jurjans, K, Kalani, R, Kalkonde, Y, Kamenova, S, Karaszewski, B, Kelly, P, Kiechl, S, Kondybayeva, A, Korv, J, Kozera, G, Kravchenko, M, Krespi, Y, Krishnamurthi, R, Kruja, J, Kutluk, K, Langhorne, P, Law, Z, Lebedynets, D, Lee, T, Leung, T, Liebeskind, D, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, M, Maia, L, Malojcic, B, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Miglane, E, Mihejeva, I, Mikulik, R, Mirrakhimov, E, Mohl, S, Munakomi, S, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, Ocampo, C, O'Donnell, M, Ogun, Y, Ogunniyi, A, Oraby, M, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Pereira, T, Peeters, A, Potpara, T, Proios, H, Rathore, F, Sacco, R, Sahathevan, R, Sandset, E, Renato Santos, I, Saposnik, G, Sarfo, F, Sargento-Freitas, J, Sharma, M, Shaw, L, Sheth, K, Shin, Y, Shobhana, A, Silva, S, Tedim Cruz, V, Thakur, K, Thapa, L, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tulloch-Reid, M, Useche, J, Vanacker, P, Vassilopoulou, S, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wojtyniak, B, Wolfe, C, Yacouba, M, Yang, J, Yifru, Y, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Zagozdzon, P, Feigin V. L., Owolabi M. O., Abd-Allah F., Akinyemi R. O., Bhattacharjee N. V., Brainin M., Cao J., Caso V., Dalton B., Davis A., Dempsey R., Duprey J., Feng W., Ford G. A., Gall S., Gandhi D., Good D. C., Hachinski V., Hacke W., Hankey G. J., Ishida M., Johnson W., Kim J., Lavados P., Lindsay P., Mahal A., Martins S., Murray C., Nguyen T. P., Norrving B., Olaiya M. T., Olalusi O. V., Pandian J., Phan H., Platz T., Ranta A., Rehman S., Roth G., Sebastian I. A., Smith A. E., Suwanwela N. C., Sylaja P. N., Thapa R., Thrift A. G., Uvere E., Vollset S. E., Yavagal D., Yaria J., Abera S. F., Akinyemi R., Dempsey R. J., Ibrahim N. M., Liu L., Ovbiagele B., Piradov M., Suwanwela N., Abanto C., Addissie A., Adeleye A. O., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar de Sousa D., Akhmetzhanova Z., Akpalu A., El Alaoui-Faris M., Ameriso S. F., Andonova S., Arsovska A., Awoniyi F. E., Bakhiet M., Barboza M. A., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bohara M., Bovet P., Budincevic H., Cadilhac D. A., Cerimagic D., Charway-Felli A., Chen C., Chin J. H., Christensen H., Chwojnicki K., Conforto A. B., Correia M., Mora Cuervo D. L., Czlonkowska A., D'Amelio M., Danielyan K. E., Davis S., Demarin V., Demchuk A. M., Dichgans M., Dokova K., Donnan G., Duran J. C., Ekeng G., Elkind M. S., Endres M., Fischer U., Flomin Y., Gankpe F., Gavidia M., Gaye Saavedra A., Gebreyohanns M., George M., Gierlotka M., Giroud M., Gnedovskaya E. V., Goncalves I. P., Gongora-Rivera F., Gunaratne P. S., Hamadeh R. R., Hamzat T. -H. K., Heldner M. R., Ibrahim E., Ihle-Hansen H., Jee S., Jiann-Shing J., Johnston S. C., Jovanovic D., Jurjans K., Kalani R., Kalkonde Y., Kamenova S., Karaszewski B., Kelly P., Kiechl S., Kondybayeva A., Korv J., Kozera G., Kravchenko M., Krespi Y., Krishnamurthi R., Kruja J., Kutluk K., Langhorne P., Law Z. K., Lebedynets D., Lee T. -H., Leung T. W., Liebeskind D. S., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion M. J., Maia L. F., Malojcic B., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Miglane E., Mihejeva I., Mikulik R., Mirrakhimov E., Mohl S., Munakomi S., Murphy S., Musa K. I., Nasreldein A., Nogueira R. G., Nolte C. H., Noubiap J. J., Novarro-Escudero N., Ocampo C., O'Donnell M., Ogun Y., Ogunniyi A., Oraby M. I., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Pereira T., Peeters A., Potpara T., Proios H., Rathore F. A., Sacco R. L., Sahathevan R., Sandset E. S., Renato Santos I., Saposnik G., Sarfo F. S., Sargento-Freitas J., Sharma M., Shaw L., Sheth K. N., Shin Y. -I., Shobhana A., Silva S. N., Tedim Cruz V., Thakur K., Thapa L. J., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wojtyniak B., Wolfe C., Yacouba M. N., Yang J., Yifru Y. M., Yock-Corrales A., Yonemoto N., Yperzeele L., Zagozdzon P., Feigin, V, Owolabi, M, Abd-Allah, F, Akinyemi, R, Bhattacharjee, N, Brainin, M, Cao, J, Caso, V, Dalton, B, Davis, A, Dempsey, R, Duprey, J, Feng, W, Ford, G, Gall, S, Gandhi, D, Good, D, Hachinski, V, Hacke, W, Hankey, G, Ishida, M, Johnson, W, Kim, J, Lavados, P, Lindsay, P, Mahal, A, Martins, S, Murray, C, Nguyen, T, Norrving, B, Olaiya, M, Olalusi, O, Pandian, J, Phan, H, Platz, T, Ranta, A, Rehman, S, Roth, G, Sebastian, I, Smith, A, Suwanwela, N, Sylaja, P, Thapa, R, Thrift, A, Uvere, E, Vollset, S, Yavagal, D, Yaria, J, Abera, S, Ibrahim, N, Liu, L, Ovbiagele, B, Piradov, M, Abanto, C, Addissie, A, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar de Sousa, D, Akhmetzhanova, Z, Akpalu, A, El Alaoui-Faris, M, Ameriso, S, Andonova, S, Arsovska, A, Awoniyi, F, Bakhiet, M, Barboza, M, Basri, H, Bath, P, Bereczki, D, Beretta, S, Berkowitz, A, Bernhardt, J, Berzina, G, Bhavsar, B, Bisharyan, M, Bohara, M, Bovet, P, Budincevic, H, Cadilhac, D, Cerimagic, D, Charway-Felli, A, Chen, C, Chin, J, Christensen, H, Chwojnicki, K, Conforto, A, Correia, M, Mora Cuervo, D, Czlonkowska, A, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Demchuk, A, Dichgans, M, Dokova, K, Donnan, G, Duran, J, Ekeng, G, Elkind, M, Endres, M, Fischer, U, Flomin, Y, Gankpe, F, Gavidia, M, Gaye Saavedra, A, Gebreyohanns, M, George, M, Gierlotka, M, Giroud, M, Gnedovskaya, E, Goncalves, I, Gongora-Rivera, F, Gunaratne, P, Hamadeh, R, Hamzat, T, Heldner, M, Ibrahim, E, Ihle-Hansen, H, Jee, S, Jiann-Shing, J, Johnston, S, Jovanovic, D, Jurjans, K, Kalani, R, Kalkonde, Y, Kamenova, S, Karaszewski, B, Kelly, P, Kiechl, S, Kondybayeva, A, Korv, J, Kozera, G, Kravchenko, M, Krespi, Y, Krishnamurthi, R, Kruja, J, Kutluk, K, Langhorne, P, Law, Z, Lebedynets, D, Lee, T, Leung, T, Liebeskind, D, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, M, Maia, L, Malojcic, B, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Miglane, E, Mihejeva, I, Mikulik, R, Mirrakhimov, E, Mohl, S, Munakomi, S, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, Ocampo, C, O'Donnell, M, Ogun, Y, Ogunniyi, A, Oraby, M, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Pereira, T, Peeters, A, Potpara, T, Proios, H, Rathore, F, Sacco, R, Sahathevan, R, Sandset, E, Renato Santos, I, Saposnik, G, Sarfo, F, Sargento-Freitas, J, Sharma, M, Shaw, L, Sheth, K, Shin, Y, Shobhana, A, Silva, S, Tedim Cruz, V, Thakur, K, Thapa, L, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tulloch-Reid, M, Useche, J, Vanacker, P, Vassilopoulou, S, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wojtyniak, B, Wolfe, C, Yacouba, M, Yang, J, Yifru, Y, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Zagozdzon, P, Feigin V. L., Owolabi M. O., Abd-Allah F., Akinyemi R. O., Bhattacharjee N. V., Brainin M., Cao J., Caso V., Dalton B., Davis A., Dempsey R., Duprey J., Feng W., Ford G. A., Gall S., Gandhi D., Good D. C., Hachinski V., Hacke W., Hankey G. J., Ishida M., Johnson W., Kim J., Lavados P., Lindsay P., Mahal A., Martins S., Murray C., Nguyen T. P., Norrving B., Olaiya M. T., Olalusi O. V., Pandian J., Phan H., Platz T., Ranta A., Rehman S., Roth G., Sebastian I. A., Smith A. E., Suwanwela N. C., Sylaja P. N., Thapa R., Thrift A. G., Uvere E., Vollset S. E., Yavagal D., Yaria J., Abera S. F., Akinyemi R., Dempsey R. J., Ibrahim N. M., Liu L., Ovbiagele B., Piradov M., Suwanwela N., Abanto C., Addissie A., Adeleye A. O., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar de Sousa D., Akhmetzhanova Z., Akpalu A., El Alaoui-Faris M., Ameriso S. F., Andonova S., Arsovska A., Awoniyi F. E., Bakhiet M., Barboza M. A., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bohara M., Bovet P., Budincevic H., Cadilhac D. A., Cerimagic D., Charway-Felli A., Chen C., Chin J. H., Christensen H., Chwojnicki K., Conforto A. B., Correia M., Mora Cuervo D. L., Czlonkowska A., D'Amelio M., Danielyan K. E., Davis S., Demarin V., Demchuk A. M., Dichgans M., Dokova K., Donnan G., Duran J. C., Ekeng G., Elkind M. S., Endres M., Fischer U., Flomin Y., Gankpe F., Gavidia M., Gaye Saavedra A., Gebreyohanns M., George M., Gierlotka M., Giroud M., Gnedovskaya E. V., Goncalves I. P., Gongora-Rivera F., Gunaratne P. S., Hamadeh R. R., Hamzat T. -H. K., Heldner M. R., Ibrahim E., Ihle-Hansen H., Jee S., Jiann-Shing J., Johnston S. C., Jovanovic D., Jurjans K., Kalani R., Kalkonde Y., Kamenova S., Karaszewski B., Kelly P., Kiechl S., Kondybayeva A., Korv J., Kozera G., Kravchenko M., Krespi Y., Krishnamurthi R., Kruja J., Kutluk K., Langhorne P., Law Z. K., Lebedynets D., Lee T. -H., Leung T. W., Liebeskind D. S., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion M. J., Maia L. F., Malojcic B., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Miglane E., Mihejeva I., Mikulik R., Mirrakhimov E., Mohl S., Munakomi S., Murphy S., Musa K. I., Nasreldein A., Nogueira R. G., Nolte C. H., Noubiap J. J., Novarro-Escudero N., Ocampo C., O'Donnell M., Ogun Y., Ogunniyi A., Oraby M. I., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Pereira T., Peeters A., Potpara T., Proios H., Rathore F. A., Sacco R. L., Sahathevan R., Sandset E. S., Renato Santos I., Saposnik G., Sarfo F. S., Sargento-Freitas J., Sharma M., Shaw L., Sheth K. N., Shin Y. -I., Shobhana A., Silva S. N., Tedim Cruz V., Thakur K., Thapa L. J., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wojtyniak B., Wolfe C., Yacouba M. N., Yang J., Yifru Y. M., Yock-Corrales A., Yonemoto N., Yperzeele L., and Zagozdzon P.

Published
2023

5. The state of stroke services across the globe: Report of World Stroke Organization–World Health Organization surveys

Author

Thrift A. G., Martins S., Johnson W., Pandian J., Abd-Allah F., Varghese C., Mahal A., Yaria J., Phan H. T., Roth G., Gall S. L., Beare R., Phan T. G., Mikulik R., Norrving B., Feigin V. Abera S. F., Addissie A., Adeleye A., Adilbekov Y., Adilbekova B., Adoukonou T. A. Aguiar de Sousa D., Akhmetzhanova Z., Akinyemi R. O., Akpalu A. MB. ChB, Ameriso S. F., Andonova S., Abanto C., Awoniyi F. E., Bakhiet M., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bovet P., Brainin M., Budincevic H., Cabral N. L., Cadilhac D A. , Caso V., Chen C., Chin J. H., Christensen H, Chwojnicki K., Conforto A. B., Cruz V. T., D'Amelio M., Danielyan K. E., Davis S., Demarin V, Dempsey R. J., Dichgans M., Dokova Donnan, G. Duran, Elizondo M. A. B., Elkind M. S., Endres M., Etedal I., Faris M. E., Fischer U., Gankpe F., Gavidia M., GayeSaavedra A., Giroud M., Gongora-Rivera F., Hachinski V., Hacke W., Hamadeh R. R., Hamzat T. K., Hankey G. J., Heldner M. R., Ibrahim N. M., Inoue M., Jee S., Jiann-Shing J., Johnston S. C., Kalkonde Y., Kamenova S., Kelly P., Khan T., Kiechl S., Kondybayeva A., Kõrv J., Kravchenko M., Krishnamurthi R., Langhorne P., Kang Z. L., Kruja J., Lavados P. M., Lebedynets D., Leung T. W., Liebeskind D. S., Lindsay P., Liu L., López-Jaramillo P., Lotufo P. A., Machline-Carrion J. M., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Mirrakhimov E., Mohl S., Murphy S., Musa K. I., Nasreldein A, Nogueira R., Nolte C. H., Noubiap J. J., Novarro-Escudero N., O'Donnell M., Ogun Y., Oraby M. I., Ovbiagele B., Ōrken D. N., Ōzdemir A. O., Ozturk S., Paccot M., Peters A., Piradov M., Platz T., Potpara T., Ranta A., Rathore F. A., Sacco R. L., Sahathevan R., Santos I. C., Saposnik G., Sarfo F. S., Sharma M., Sheth K. N., Shobhana A., Silva S. N., Suwanwela N. C., Sylaja P. N., Thakur K., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tsong-Hai L., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Venketasubramanian N., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wolfe C, Yifru M. Y., YockCorrales A., Yonemoto N., Yperzeele L., Owolabi, MO, Thrift, AG, Martins, S, Johnson, W, Pandian, J, Abd-Allah, F, Varghese, C, Mahal, A, Yaria, J, Phan, HT, Roth, G, Gall, SL, Beare, R, Phan, TG, D'Amelio M, Mikulik, R, Norrving, B, Feigin, VL, and Thrift A. G., Martins S., Johnson W., Pandian J., Abd-Allah F., Varghese C., Mahal A., Yaria J., Phan H. T., Roth G., Gall S. L., Beare R., Phan T. G., Mikulik R., Norrving B., Feigin V. Abera S.F., Addissie A., Adeleye A., Adilbekov Y., Adilbekova B., Adoukonou T.A. Aguiar de Sousa D., Akhmetzhanova Z., Akinyemi R.O., Akpalu A. MB. ChB , Ameriso S.F. , Andonova S., Abanto C., Awoniyi F.E., Bakhiet M., Basri H., Bath, P.M., Bereczki D., Beretta S., Berkowitz A.L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M.S., Bovet P., Brainin, M., Budincevic H., Cabral N.L., , Cadilhac D A. , Caso V., , Chen C., Chin J.H. , Christensen H, , Di, Chwojnicki K., Conforto A.B., Cruz V.T., D'Amelio M., Danielyan K.E., Davis, S., Demarin V, Dempsey R.J., Dichgans M., Dokova, Donnan, G., Duran, J., Elizondo M.A.B., Elkind M.S., Endres M., Etedal I., Faris M.E., Fischer U., Gankpe F., Gavidia M., GayeSaavedra A., Giroud M., Gongora-Rivera F., Hachinski V. , Hacke, W., Hamadeh R.R., Hamzat T.K., Hankey G.J., Heldner M.R., Ibrahim, N.M., Inoue M., Jee S., Jiann-Shing J., Johnston S. C., Kalkonde Y., Kamenova S., Kelly P., Khan T., Kiechl S., Kondybayeva A., Kõrv J., Kravchenko M., Krishnamurthi R., Langhorne, P., Kang Z.L., Kruja, J., Lavados P.M., Lebedynets D., Leung T.W., Liebeskind D.S., Lindsay P., Liu, L., López-Jaramillo P., Lotufo P.A., Machline-Carrion J.M., Markus, H.S., Marquez-Romero J.M., Medina M.T., Medukhanova S., Mehndiratta M.M., Mirrakhimov E., Mohl S., Murphy S., Musa K.I., Nasreldein A, Nogueira R., Nolte C.H., Norrving B., Noubiap J.J., Novarro-Escudero N., O'Donnell M., Ogun Y., Oraby M.I., Ovbiagele B., Ōrken D.N., Ōzdemir A.O., Ozturk S., Paccot M., Peters A., Piradov, M., Platz T., Potpara T., Ranta A., Rathore F.A., Roth G., Sacco R.L., Sahathevan R., Santos I.C., Saposnik G., Sarfo F.S., Sharma M., Sheth K.N., Shobhana A., Silva, S.N., Suwanwela N. C., Sylaja P.N., Thakur K., Toni D., Topcuoglu M.A., Torales J., Towfighi A., Truelsen, T., Tsiskaridze A., Tsong-Hai L., Tulloch-Reid M., Useche J.N., Vanacker P., Vassilopoulou S., Venketasubramanian N., Vukorepa G., Vuletic V., Wahab K.W., Wang W., Wijeratne T., Wolfe C, Yifru M.Y., YockCorrales A., Yonemoto N., Yperzeele L.

Subjects
Gerontology, medicine.medical_specialty, medicine.medical_treatment, media_common.quotation_subject, Globe, Commission, stroke quadrangle, Global Health, World Health Organization, World health, Article, Stroke service, rehabilitation, low and middle-income countrie, 03 medical and health sciences, 0302 clinical medicine, State (polity), prevention, Acute care, Surveys and Questionnaires, medicine, Humans, 030212 general & internal medicine, high-income countrie, Stroke, Developing Countries, media_common, Stroke services, Rehabilitation, business.industry, Stroke Rehabilitation, medicine.disease, 3. Good health, medicine.anatomical_structure, Neurology, low- and middle-income countrie, Settore MED/26 - Neurologia, acute care, business, 030217 neurology & neurosurgery
Abstract

Background Improving stroke services is critical for reducing the global stroke burden. The World Stroke Organization–World Health Organization– Lancet Neurology Commission on Stroke conducted a survey of the status of stroke services in low and middle-income countries (LMICs) compared to high-income countries. Methods Using a validated World Stroke Organization comprehensive questionnaire, we collected and compared data on stroke services along four pillars of the stroke quadrangle (surveillance, prevention, acute stroke, and rehabilitation) in 84 countries across World Health Organization regions and economic strata. The World Health Organization also conducted a survey of non-communicable diseases in 194 countries in 2019. Results Fewer surveillance activities (including presence of registries, presence of recent risk factors surveys, and participation in research) were reported in low-income countries than high-income countries. The overall global score for prevention was 40.2%. Stroke units were present in 91% of high-income countries in contrast to 18% of low-income countries (p Conclusions There is an urgent need to improve access to stroke units and services globally especially in LMICs. Countries with less stroke services can adapt strategies from those with better services. This could include establishment of a framework for regular monitoring of stroke burden and services, implementation of integrated prevention activities and essential acute stroke care services, and provision of interdisciplinary care for stroke rehabilitation.

Published
2021

7. The state of stroke services across the globe: Report of World Stroke Organization–World Health Organization surveys

Author

Owolabi, M, Thrift, A, Martins, S, Johnson, W, Pandian, J, Abd-Allah, F, Varghese, C, Mahal, A, Yaria, J, Phan, H, Roth, G, Gall, S, Beare, R, Phan, T, Mikulik, R, Norrving, B, Feigin, V, on behalf of the Stroke Experts Collaboration, G, Abera, S, Addissie, A, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar, D, Akhmetzhanova, Z, Akinyemi, R, Akpalu, A, Ameriso, S, Andonova, S, Abanto, C, Awoniyi, F, Bakhiet, M, Basri, H, Bath, P, Bereczki, D, Beretta, S, Berkowitz, A, Bernhardt, J, Berzina, G, Bhavsar, B, Bisharyan, M, Bovet, P, Brainin, M, Budincevic, H, Cabral, N, Cadilhac, D, Caso, V, Chen, C, Chin, J, Christensen, H, Chwojnicki, K, Conforto, A, Cruz, V, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Dempsey, R, Dichgans, M, Dokova, Donnan, G, Duran, J, Elizondo, M, Elkind, M, Endres, M, Etedal, I, Faris, M, Fischer, U, Gankpe, F, Gavidia, M, Gaye-Saavedra, A, Giroud, M, Gongora-Rivera, F, Hachinski, V, Hacke, W, Hamadeh, R, Hamzat, T, Hankey, G, Heldner, M, Ibrahim, N, Inoue, M, Jee, S, Jiann-Shing, J, Johnston, S, Kalkonde, Y, Kamenova, S, Kelly, P, Khan, T, Kiechl, S, Kondybayeva, A, Korv, J, Kravchenko, M, Krishnamurthi, R, Langhorne, P, Kang, Z, Kruja, J, Lavados, P, Lebedynets, D, Leung, T, Liebeskind, D, Lindsay, P, Liu, L, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, J, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Mirrakhimov, E, Mohl, S, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, O'Donnell, M, Ogun, V, Oraby, M, Ovbiagele, B, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Peters, A, Piradov, M, Platz, T, Potpara, T, Ranta, A, Rathore, F, Sacco, R, Sahathevan, R, Santos, I, Saposnik, G, Sarfo, F, Sharma, M, Sheth, K, Shobhana, A, Silva, S, Suwanwela, N, Sylaja, P, Thakur, K, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tsong-Hai, L, Tulloch-Reid, M, Useche, J, Vanacker, P, Vassilopoulou, S, Venketasubramanian, N, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wolfe, C, Yifru, M, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Owolabi M. O., Thrift A. G., Martins S., Johnson W., Pandian J., Abd-Allah F., Varghese C., Mahal A., Yaria J., Phan H. T., Roth G., Gall S. L., Beare R., Phan T. G., Mikulik R., Norrving B., Feigin V. L., on behalf of the Stroke Experts Collaboration Group, Abera S. F., Addissie A., Adeleye A., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar D. S. D., Akhmetzhanova Z., Akinyemi R. O., Akpalu A., Ameriso S. F., Andonova S., Abanto C., Awoniyi F. E., Bakhiet M., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bovet P., Brainin M., Budincevic H., Cabral N. L., Cadilhac D. A., Caso V., Chen C., Chin J. H., Christensen H., Chwojnicki K., Conforto A. B., Cruz V. T., D'Amelio M., Danielyan K. E., Davis S., Demarin V., Dempsey R. J., Dichgans M., Donnan G., Duran J., Elizondo M. A. B., Elkind M. S., Endres M., Etedal I., Faris M. E., Fischer U., Gankpe F., Gavidia M., Gaye-Saavedra A., Giroud M., Gongora-Rivera F., Hachinski V., Hacke W., Hamadeh R. R., Hamzat T. K., Hankey G. J., Heldner M. R., Ibrahim N. M., Inoue M., Jee S., Jiann-Shing J., Johnston S., Kalkonde Y., Kamenova S., Kelly P., Khan T., Kiechl S., Kondybayeva A., Korv J., Kravchenko M., Krishnamurthi R., Langhorne P., Kang Z. L., Kruja J., Lavados P. M., Lebedynets D., Leung T. W., Liebeskind D. S., Lindsay P., Liu L., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion J. M., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Mirrakhimov E., Mohl S., Murphy S., Musa K. I., Nasreldein A., Nogueira R., Nolte C. H., Noubiap J. J., Novarro-Escudero N., O'Donnell M., Ogun V., Oraby M. I., Ovbiagele B., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Peters A., Piradov M., Platz T., Potpara T., Ranta A., Rathore F. A., Sacco R. L., Sahathevan R., Santos I. C., Saposnik G., Sarfo F. S., Sharma M., Sheth K. N., Shobhana A., Silva S. N., Suwanwela N., Sylaja P. N., Thakur K., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tsong-Hai L., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Venketasubramanian N., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wolfe C., Yifru M. Y., Yock-Corrales A., Yonemoto N., Yperzeele L., Owolabi, M, Thrift, A, Martins, S, Johnson, W, Pandian, J, Abd-Allah, F, Varghese, C, Mahal, A, Yaria, J, Phan, H, Roth, G, Gall, S, Beare, R, Phan, T, Mikulik, R, Norrving, B, Feigin, V, on behalf of the Stroke Experts Collaboration, G, Abera, S, Addissie, A, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar, D, Akhmetzhanova, Z, Akinyemi, R, Akpalu, A, Ameriso, S, Andonova, S, Abanto, C, Awoniyi, F, Bakhiet, M, Basri, H, Bath, P, Bereczki, D, Beretta, S, Berkowitz, A, Bernhardt, J, Berzina, G, Bhavsar, B, Bisharyan, M, Bovet, P, Brainin, M, Budincevic, H, Cabral, N, Cadilhac, D, Caso, V, Chen, C, Chin, J, Christensen, H, Chwojnicki, K, Conforto, A, Cruz, V, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Dempsey, R, Dichgans, M, Dokova, Donnan, G, Duran, J, Elizondo, M, Elkind, M, Endres, M, Etedal, I, Faris, M, Fischer, U, Gankpe, F, Gavidia, M, Gaye-Saavedra, A, Giroud, M, Gongora-Rivera, F, Hachinski, V, Hacke, W, Hamadeh, R, Hamzat, T, Hankey, G, Heldner, M, Ibrahim, N, Inoue, M, Jee, S, Jiann-Shing, J, Johnston, S, Kalkonde, Y, Kamenova, S, Kelly, P, Khan, T, Kiechl, S, Kondybayeva, A, Korv, J, Kravchenko, M, Krishnamurthi, R, Langhorne, P, Kang, Z, Kruja, J, Lavados, P, Lebedynets, D, Leung, T, Liebeskind, D, Lindsay, P, Liu, L, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, J, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Mirrakhimov, E, Mohl, S, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, O'Donnell, M, Ogun, V, Oraby, M, Ovbiagele, B, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Peters, A, Piradov, M, Platz, T, Potpara, T, Ranta, A, Rathore, F, Sacco, R, Sahathevan, R, Santos, I, Saposnik, G, Sarfo, F, Sharma, M, Sheth, K, Shobhana, A, Silva, S, Suwanwela, N, Sylaja, P, Thakur, K, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tsong-Hai, L, Tulloch-Reid, M, Useche, J, Vanacker, P, Vassilopoulou, S, Venketasubramanian, N, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wolfe, C, Yifru, M, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Owolabi M. O., Thrift A. G., Martins S., Johnson W., Pandian J., Abd-Allah F., Varghese C., Mahal A., Yaria J., Phan H. T., Roth G., Gall S. L., Beare R., Phan T. G., Mikulik R., Norrving B., Feigin V. L., on behalf of the Stroke Experts Collaboration Group, Abera S. F., Addissie A., Adeleye A., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar D. S. D., Akhmetzhanova Z., Akinyemi R. O., Akpalu A., Ameriso S. F., Andonova S., Abanto C., Awoniyi F. E., Bakhiet M., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bovet P., Brainin M., Budincevic H., Cabral N. L., Cadilhac D. A., Caso V., Chen C., Chin J. H., Christensen H., Chwojnicki K., Conforto A. B., Cruz V. T., D'Amelio M., Danielyan K. E., Davis S., Demarin V., Dempsey R. J., Dichgans M., Donnan G., Duran J., Elizondo M. A. B., Elkind M. S., Endres M., Etedal I., Faris M. E., Fischer U., Gankpe F., Gavidia M., Gaye-Saavedra A., Giroud M., Gongora-Rivera F., Hachinski V., Hacke W., Hamadeh R. R., Hamzat T. K., Hankey G. J., Heldner M. R., Ibrahim N. M., Inoue M., Jee S., Jiann-Shing J., Johnston S., Kalkonde Y., Kamenova S., Kelly P., Khan T., Kiechl S., Kondybayeva A., Korv J., Kravchenko M., Krishnamurthi R., Langhorne P., Kang Z. L., Kruja J., Lavados P. M., Lebedynets D., Leung T. W., Liebeskind D. S., Lindsay P., Liu L., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion J. M., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Mirrakhimov E., Mohl S., Murphy S., Musa K. I., Nasreldein A., Nogueira R., Nolte C. H., Noubiap J. J., Novarro-Escudero N., O'Donnell M., Ogun V., Oraby M. I., Ovbiagele B., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Peters A., Piradov M., Platz T., Potpara T., Ranta A., Rathore F. A., Sacco R. L., Sahathevan R., Santos I. C., Saposnik G., Sarfo F. S., Sharma M., Sheth K. N., Shobhana A., Silva S. N., Suwanwela N., Sylaja P. N., Thakur K., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tsong-Hai L., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Venketasubramanian N., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wolfe C., Yifru M. Y., Yock-Corrales A., Yonemoto N., and Yperzeele L.

Abstract

Background: Improving stroke services is critical for reducing the global stroke burden. The World Stroke Organization–World Health Organization–Lancet Neurology Commission on Stroke conducted a survey of the status of stroke services in low and middle-income countries (LMICs) compared to high-income countries. Methods: Using a validated World Stroke Organization comprehensive questionnaire, we collected and compared data on stroke services along four pillars of the stroke quadrangle (surveillance, prevention, acute stroke, and rehabilitation) in 84 countries across World Health Organization regions and economic strata. The World Health Organization also conducted a survey of non-communicable diseases in 194 countries in 2019. Results: Fewer surveillance activities (including presence of registries, presence of recent risk factors surveys, and participation in research) were reported in low-income countries than high-income countries. The overall global score for prevention was 40.2%. Stroke units were present in 91% of high-income countries in contrast to 18% of low-income countries (p < 0.001). Acute stroke treatments were offered in ∼ 60% of high-income countries compared to 26% of low-income countries (p = 0.009). Compared to high-income countries, LMICs provided less rehabilitation services including in-patient rehabilitation, home assessment, community rehabilitation, education, early hospital discharge program, and presence of rehabilitation protocol. Conclusions: There is an urgent need to improve access to stroke units and services globally especially in LMICs. Countries with less stroke services can adapt strategies from those with better services. This could include establishment of a framework for regular monitoring of stroke burden and services, implementation of integrated prevention activities and essential acute stroke care services, and provision of interdisciplinary care for stroke rehabilitation.

Published
2021

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