Stroke services in MENA: What is there and what is needed

Area of Science:

• Neurology
• Public Health
• Healthcare Management

Background:

• Stroke is a growing global health challenge, particularly in the Middle East and North Africa (MENA) region.
• The shift from infectious to non-communicable diseases increases the future burden of stroke care in MENA's low-to-middle income economies.
• Understanding the current state of stroke services in MENA is crucial for informing policy and addressing healthcare gaps.

Purpose of the Study:

• To assess the current status of stroke services across the Middle East and North Africa (MENA) region.
• To identify gaps in stroke care, including risk factor screening, acute management, diagnostics, and post-discharge services.
• To provide data for policymakers to improve stroke treatment and patient outcomes in MENA.

Main Methods:

• An online survey was distributed to stroke specialists from 16 countries in the MENA region.
• The survey covered key aspects of stroke care: risk factor screening, acute management, diagnostics, medications, post-discharge services, and stroke registries.
• Data analysis focused on the availability and utilization of various stroke care components.

Main Results:

• All surveyed MENA countries have access to neuroimaging studies and medications for secondary stroke prevention.
• While 15 countries offer intravenous thrombolysis (IVT) and 13 offer mechanical thrombectomy (MT), the administration rates for IVT remain low in many countries.
• Stroke units are lacking in 4 countries, and stroke registries and structured training programs require significant implementation in most participating nations.

Conclusions:

• Despite the availability of advanced treatments like IVT and MT in most MENA countries, their low utilization and insufficient stroke unit capacity highlight significant service gaps.
• The lack of comprehensive stroke registries and structured training programs further impedes effective stroke management and research in the region.
• Further detailed studies are necessary to accurately ascertain the status of stroke services and guide targeted interventions in the MENA region.