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Advanced Neurology Stroke care in sub-Sahara Africa

deaths reported in 2019, with 51% of the deaths occurring countries generally share similar socioeconomic challenges
in men and 49% in women. Furthermore, stroke-related and health issues, which are distinct from those faced by
disability-adjusted life years (DALYs) are equally high, North African countries. These differences can influence
estimated at 143 million years of healthy life lost each disease prevalence, health-care access, and outcomes,
year. These figures are even more dire in resource-limited hence the need to specifically focus on the unique public
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settings. The age-standardized annual incidence rate of health challenges prevalent in SSA.
stroke in Africa, as reported by both community-based
and hospital-based studies, is estimated at an alarming 2. Review method
316/100,000 population. 2 A systematic search of published relevant articles was
Sub-Saharan Africa (SSA) is extremely diverse in culture performed between 1970 and 2023 for this review.
and ethnicity and consists of countries categorized as low- The searches were conducted in five main databases:
income and lower-middle-income economies based on the PubMed, EMBASE, Google Scholar, MEDLINE [Ovid],
2024 World Bank Atlas classification. There are a total of and CINAHL. The keywords used in the search include
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46 countries in SSA (Figure 1), with a combined population terms describing stroke care, such as “acute stroke care,”
of about 1.1 billion people. Notably, six countries (Nigeria, “primary and secondary stroke prevention,” “stroke
Ethiopia, the Democratic Republic of Congo, South Africa, rehabilitation,” “stroke risk factors,” “stroke epidemiology,”
Ghana, and Mozambique) account for nearly 40% of the “stroke incidence,” “prevalence,” “mortality and morbidity,”
population. This review focuses on SSA rather than the “organized stroke care,” “stroke treatment,” and “access to
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entire continent due to significant economic, social, and stroke care.” All searches were limited to studies conducted
health system-related differences that exist across the in SSA. Additional articles were selected from reference
Sahara divide. Countries in Northern Africa tend to have lists of relevant publications and included in this review.
higher gross domestic product overall. In contrast, SSA The authors (FC and AM) independently reviewed and

Figure 1. Sub-Saharan African countries according to United Nations Development Program Classification

Volume 3 Issue 2 (2024) 2 doi: 10.36922/an.2804