Stroke and thrombolysis in developing countries

被引:128
作者
Pandian, Jeyaraj Durai
Padma, Vasantha
Vijaya, Pamidimukkala
Sylaja, P. N.
Murthy, Jagaralpudi M. K.
机构
[1] Royal Brisbane & Womens Hosp, Stroke Unit, Dept Neurol, Brisbane, Qld 4029, Australia
[2] Christian Med Coll & Hosp, Dept Neurol, Ludhiana, Punjab, India
[3] All India Inst Med Sci, Dept Neurol, New Delhi, India
[4] Lalitha Super Specialty Hosp, Ankineedu Stroke Unit, Heart & Brain Ctr, Guntur, Andhra Pradesh, India
[5] Sree Chitra Tirunal Inst Med Sci & Technol, Dept Neurol, Thiruvananthapuram, Kerala, India
[6] Care Hosp, Inst Neurol Sci, Hyderabad, Andhra Pradesh, India
关键词
developing countries; stroke; tPA; thrombolysis therapy;
D O I
10.1111/j.1747-4949.2007.00089.x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background Over the past few decades, the burden of stroke in developing countries has grown to epidemic proportions. Two-thirds of global stroke occurs in low- and middle-income countries. We have found that little information is obtainable concerning the availability of thrombolysis therapy in developing countries. Summary of review The epidemiology of stroke is well investigated in the developed world; however, in the developing world stroke is less well documented. Most of the available stroke data from these countries are hospital-based. Stroke thrombolysis is currently used in few developing countries like Brazil, Argentina, Senegal, Iran, Pakistan, China, Thailand, and India. The two main barriers for implementation of thrombolysis therapy in developing countries are the high cost of tissue plasminogen activator and lack of proper infrastructure. Most of the centers with the infrastructure to deliver thrombolysis for stroke are predominantly private sector, and only available in urban areas. Conclusion Until a more cost-effective thrombolytic agent and the proper infrastructure for widespread use of thrombolysis therapy are available, developing nations should focus on primary and secondary stroke prevention strategies and the establishment of stroke units wherever possible. Such multi-faceted approaches will be more cost-effective for developing countries than the use of thrombolysis.
引用
收藏
页码:17 / 26
页数:10
相关论文
共 98 条
[21]  
Dalal PM, 1997, INDIAN J MED RES, V106, P325
[22]   Stroke in rural Ecuador -: A three-phase, door-to-door survey [J].
Del Brutto, OH ;
Idrovo, L ;
Mosquera, A ;
Navas, C ;
Santibáñez, R ;
Cuesta, F ;
Díaz-Calderón, E .
NEUROLOGY, 2004, 63 (10) :1974-1975
[23]   STROKE SUBTYPES AMONG HISPANICS LIVING IN GUAYAQUIL, ECUADOR - RESULTS FROM THE LUIS-VERNAZA-HOSPITAL STROKE REGISTRY [J].
DELBRUTTO, OH ;
MOSQUERA, A ;
SANCHEZ, X ;
SANTOS, J ;
NOBOA, CA .
STROKE, 1993, 24 (12) :1833-1836
[24]   Economic benefit of increasing utilization of intravenous tissue plasminogen activator for acute ischemic stroke in the United States [J].
Demaerschalk, BM ;
Yip, TR .
STROKE, 2005, 36 (11) :2500-2503
[25]  
Dhamija R K, 1998, J Assoc Physicians India, V46, P351
[26]  
Donnan G, 1998, STROKE, V29, P1730
[27]   Cost-effectiveness of tissue plasminogen activator for acute ischemic stroke [J].
Fagan, SC ;
Morgenstern, LB ;
Petitta, A ;
Ward, RE ;
Tilley, BC ;
Marler, JR ;
Levine, SR ;
Broderick, JP ;
Kwiatkowski, TG ;
Frankel, M ;
Brott, TG ;
Walker, MD .
NEUROLOGY, 1998, 50 (04) :883-890
[28]   Stroke epidemiology: a review of population-based studies of incidence, prevalence, and case-fatality in the late 20th century [J].
Feigin, VL ;
Lawes, CMM ;
Bennett, DA ;
Anderson, CS .
LANCET NEUROLOGY, 2003, 2 (01) :43-53
[29]  
FEIGIN VL, 1995, MAYO CLIN PROC, V70, P847
[30]   Intra-arterial prourokinase for acute ischemic stroke - The PROACT II study: A randomized controlled trial [J].
Furlan, A ;
Higashida, R ;
Wechsler, L ;
Gent, M ;
Rowley, H ;
Kase, C ;
Pessin, M ;
Ahuja, A ;
Callahan, F ;
Clark, WM ;
Silver, F ;
Rivera, F .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1999, 282 (21) :2003-2011