Prevention, management, and rehabilitation of stroke in low- and middle-income countries

eNeurologicalSci

J. Jaime Miranda¹  Dong Zhao²  Janet Bettger³  Chaoyun Li⁴  Lijing L. Yan⁴  Jie Chen⁵  Valery Feigin⁶  Martin O'Donnell⁷  Yishan Zhu⁸  Yangfeng Wu⁸  Rong Luo⁸ 

[1] CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru;Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China;Duke School of Nursing, Duke University, Durham, USA;Global Health Research Center, Duke Kunshan University, Kunshan, China;Institute for Medical Humanities, Peking University Health Science Center, Beijing, China;National Institute for Stroke and Applied Neuroscience, Auckland University of Technology, Auckland, New Zealand;National University of Ireland Galway, Galway, Ireland;The George Institute for Global Health at Peking University Health Science Center, Beijing, China;

关键词: Stroke;    Prevention;    Treatment;    Rehabilitation;    Low- and middle-income countries;   

DOI  :  10.1016/j.ensci.2016.02.011

来源: DOAJ

【 摘 要 】

Although stroke incidence in high-income countries (HICs) decreased over the past four decades, it increased dramatically in low- and middle-income countries (LMICs). In this review, we describe the current status of primary prevention, treatment, and management of acute stroke and secondary prevention of and rehabilitation after stroke in LMICs. Although surveillance, screening, and accurate diagnosis are important for stroke prevention, LMICs face challenges in these areas due to lack of resources, awareness, and technical capacity. Maintaining a healthy lifestyle, such as no tobacco use, healthful diet, and physical activity are important strategies for both primary and secondary prevention of stroke. Controlling high blood pressure is also critically important in the general population and in the acute stage of hemorrhagic stroke. Additional primary prevention strategies include community-based education programs, polypill, prevention and management of atrial fibrillation, and digital health technology. For treatment of stroke during the acute stage, specific surgical procedures and medications are recommended, and inpatient stroke care units have been proven to provide high quality care. Patients with a chronic condition like stroke may require lifelong pharmaceutical treatment, lifestyle maintenance and self-management skills, and caregiver and family support, in order to achieve optimal health outcomes. Rehabilitation improves physical, speech, and cognitive functioning of disabled stroke patients. It is expected that home- or community-based services and tele-rehabilitation may hold special promise for stroke patients in LMICs.

【 授权许可】

Unknown