Two major problems.
1. The chances of ever getting tPA delivered in anything under 4.5 hours is nigh impossible for most of the continent.
2. Mechanical thrombectomy in a reasonable time is also highly unlikely.
To address this lack of immediate interventions the services in Africa will have to rely on 100% recovery protocols. Since they don't exist yet and no one is working on them, I see little hope for stroke patients in Africa. At least until we get some stroke leadership that prioritizes 100% recovery protocols.
You don't want to get into dangerous therapies like this:
Train track stroke therapy?
The latest here:
Stroke services in Africa: What is there and what is needed
Abstract
Background:
Over the past few years, the incidence and prevalence of stroke has been rising in most African countries and has been reported as one of the leading causes of morbidity and mortality. To study this problem, we need to realize the quality and availability of stroke care services as a priori to improve them.
Methods and Results:
In this study, we investigated the availability of different stroke-related services in 17 countries from different African regions. An online survey was conducted and fulfilled by stroke specialists and included primary prevention, acute management, diagnostic tools, medications, postdischarge services, and stroke registries. The results showed that although medications for secondary prevention are available, yet many other services are lacking in various countries.
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