Stroke systems of care in South-East Asia Region (SEAR): commonalities and diversities

Sebastian, Ivy A.; Gandhi, Dorcas B.C.; Sylaja, Padmavati N.; Paudel, Raju; Kalkonde, Yogeshwar V.; Yangchen, Yangchen; Gunasekara, Harsha; Injety, Ranjit J.; Vijayanand, Pranay J.; Chawla, Nistara S.; Oo, San; Hla, Khin Myo; Tenzin, Tashi; Pandian, Jeyaraj D.

doi:10.1016/j.lansea.2023.100289

Cited by 4 publications

(9 citation statements)

References 52 publications

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“…This indicates that by EMS, only one-half of stroke patients are transferred to the stroke center. 41 …”

Section: Discussionmentioning

confidence: 99%

“…This indicates that by EMS, only one-half of stroke patients are transferred to the stroke center. 41 Comparing problems of EMS in developed countries such as the United States, EMS providers reported insufficient LVO training and knowledge gaps in LVO, stroke severity scales, and stroke center levels. Systematic efforts are required to improve and standardize the educational content and delivery of LVO education in order to save more lives.…”

mentioning

confidence: 99%

“…Unfortunately, thrombolysis use is still limited with a rate of only 0.18-8.04%. 41 In Indonesia, the Minister of Health Regulation 2023 determines the claim value for thrombolysis agents such as alteplase as a standard treatment for health facilities to bill claims to National Health Coverage. 43 In addition, the paucity of mechanical thrombectomy coverage by national insurance has significant repercussions.…”

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confidence: 99%

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Endovascular Thrombectomy for Acute Ischemic Stroke in Indonesia: Challenging and Strategic Planning

Rilianto,

Kurniawan,

Rajab

et al. 2024

NDT

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High rates of morbidity and mortality indicate that stroke is a major health concern. Unfortunately, the management of ischemic stroke is hindered by several obstacles, particularly in developing countries such as Indonesia, where the burden of morbidity and mortality remains high. In this literature review, we intend to conduct a thorough investigation and analysis of the obstacles to stroke thrombectomy in developing countries, with a focus on Indonesia. Even though numerous studies and recent advances in thrombectomy techniques have been developed, many centers around the world continue to struggle to implement them. The majority of these institutions are located in developing nations like Indonesia. It faces numerous obstacles, including a lack of public awareness, infrastructure, human resources, and financial difficulties. The absence of early education and large-scale campaigns contributes to the dearth of public awareness. Inadequate imaging facilities, prehospital and referral systems, as well as disparities in healthcare expenditure and accessibility, contribute to the absence of infrastructure. Inadequate numbers of neurointerventionists, neurologists, and neurosurgeons, as well as a disparate distribution of these professionals, contribute to human resource issues. Inadequate national insurance coverage, high import tariffs on medical devices, and the high cost of healthcare have a negative impact on the financial situation. We provide related strategies regarding the current situation in Indonesia based on the recent evidence and comparison with developed countries. Academic institutions, medical associations, and government agencies must collaborate to overcome these challenges.

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“…This indicates that by EMS, only one-half of stroke patients are transferred to the stroke center. 41 …”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Endovascular Thrombectomy for Acute Ischemic Stroke in Indonesia: Challenging and Strategic Planning

Rilianto,

Kurniawan,

Rajab

et al. 2024

NDT

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“…One such example is the work by Christian Medical College & Hospital, Ludhiana, Punjab, India, with the World Health Organization Southeast Asia Region, which has developed and implemented customized capacity building programs for countries in the region. 7 A practical and cost-effective solution is online training, similar to the educational program organized in 2022 by the Global Stroke Alliance, which successfully trained >3000 rehabilitation professionals in Brazil.…”

Section: Strategies To Improve Access In Lmicsmentioning

confidence: 99%

“…A comparative analysis of HIC and LMIC services is provided in the Table. 7,9,10 DISCUSSION AND CONCLUSIONS Despite identification of barriers and testing probable solutions, the state of stroke rehabilitation in LMICs remains poor. The multifaceted causes aiding to this situation make it essential for various fields like health care, industry, government, public, and those with lived experience to join hands to develop customized solutions.…”

Section: Policies Programmes and Future Needs To Improve Stroke Rehab...mentioning

confidence: 99%

Global Access to Stroke Rehabilitation: A Narrative Synthesis of Comparative Highlights

Gandhi,

Baggio,

D’Souza

et al. 2024

Stroke

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Stroke in Asia

Tan,

Pandian,

Liu

et al. 2024

Cerebrovasc Dis Extra

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Background There is a significant burden of stroke in Asia. Asia has the largest population in the world in 2023, estimated at 4.7 billion. Approximately 9.5-10.6 million strokes will be anticipated annually in the backdrop of a diverse group of well-developed and less developed countries with large disparities in stroke care resources. In addition, Asian countries are in varying phases of epidemiological transition. Summary In this review, we examined recent epidemiological features of ischaemic stroke and intracerebral haemorrhage in Asia with recent developments in hyperacute stroke reperfusion therapy and technical improvements in intracerebral haemorrhage. The article also discussed the spectrum of cerebrovascular diseases in Asia which include intracranial atherosclerosis, intracerebral haemorrhage, infective aetiologies of stroke, moyamoya disease, vascular dissection, radiation vasculopathy and cerebral venous thrombosis. Key Messages The review of selected literature and recent updates, call for attention to the different requirements for resources within Asia and highlights the breadth of cerebrovascular diseases still requiring further research and more effective therapies,

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Stroke systems of care in South-East Asia Region (SEAR): commonalities and diversities

Cited by 4 publications

References 52 publications

Endovascular Thrombectomy for Acute Ischemic Stroke in Indonesia: Challenging and Strategic Planning

Endovascular Thrombectomy for Acute Ischemic Stroke in Indonesia: Challenging and Strategic Planning

Global Access to Stroke Rehabilitation: A Narrative Synthesis of Comparative Highlights

Stroke in Asia

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