Stroke in Argentina

Abstract

Latin America encompasses 22 countries with approximately 500 million inhabitants. Argentina, located at the extreme south of the American continent, is one of the largest and most populated countries in the region. With a total area of 2 766 890 km 2 (1 068 302 sq. mi), it is the eighth largest country in the world, and the largest among Spanish-speaking nations (1). The population was 37 869 723 inhabitants in 2004 and is estimated today at 40 million people with 88Á6% localised in urban regions. Buenos Aires with three million people is among the 10 most populated cities in the world. The Province of Buenos Aires, with 15 million people, heavily concentrates the country's population. Argentina's GDP was calculated at 326Á474 billion dollars in 2008 (2). Life expectancy at birth is 75 years and the adult literacy rate is 97Á6 (28th in the world) (3). In contrast to most other Latin American countries, which have a large majority of indigenous people, most Argentineans are of Spanish and Italian ancestry. To fully understand the context for medical practice in general and cerebrovascular disease in particular, it is necessary to be familiar with some of the cultural and economic factors that heavily influence medical practice in Argentina. Conflicts of interest: None.

Barriers of Thrombolysis Therapy in Developing Countries

“…The Argentina health system annual revenue in recent years has been approximately 7% of the gross national product. However, 40% of the Argentine population does not have medical insurance which receive medical attention free of cost at public hospitals [21]. Governments must understand the importance of vascular disease prevention and treatment and assign sufficient resources for this purpose.…”

“…Emergency ambulance services are being widely available in Brazil [12]. The health care system in Argentina provides limited incentives to health care providers and hospitals to offer specialized care for stroke patients [21]. Seven stroke units have been built in Argentina however, 1.3% of stroke patients in Argentina receive thrombolysis therapy and 6.9% are admitted in the stroke unit [20, 21].…”

“…The health care system in Argentina provides limited incentives to health care providers and hospitals to offer specialized care for stroke patients [21]. Seven stroke units have been built in Argentina however, 1.3% of stroke patients in Argentina receive thrombolysis therapy and 6.9% are admitted in the stroke unit [20, 21]. Thus availability of skilled manpower to deliver thrombolysis and multidisciplinary care in a dedicated stroke unit is very limited in developing countries.…”

Differences in Ischemic and Hemorrhagic Recurrence Rates among Race-Ethnic Groups in the PRoFESS Secondary Stroke Prevention Trial

“…The PRoFESS study included Asians classified as from China, south‐Asia, and ‘other Asian’. In Hispanic‐Latins, a higher prevalence of hypertension and poor control of most vascular risk factors may account for the greater incidence of ICH noted in our and other analyses . A genetic component is possible, although difficult to prove as almost half of all Hispanic‐Latins included in PRoFESS were from Argentina where most patients are of European ancestry in contrast to ‘Latin‐Hispanics’ from most other countries in Latin America that have up to a 90% local native origin.…”

Translational Research: From Observational Studies to Health Policy

“…Only 12% of patients were admitted to a stroke unit, and only 1.1% of the patients with ischemic stroke received thrombolysis (similar to other reports from Argentina). 8,11 Interestingly, although in general patients did not have complete vascular evaluations, those admitted to what the authors defined as "stroke units" had suboptimal but significantly greater rates of laboratory testing compared with those evaluated in the general wards. This underscores the value of dedicated vascular units even when overall management is not adequate.…”