Implementing Acute Stroke Services in Sub-Saharan Africa: Steps, Progress, and Perspectives from the Tanzania Stroke Project

作者：Sarah Shali Matuja, Christine Tunkl, Tamer Roushdy, Linxin Li, Menglu Ouyang, Faddi G. Saleh Velez, Meron Awraris Gebrewold, Jatinder S. Minhas, Zhe Kang Law, Aristeidis H. Katsanos, Teresa Ullberg, Maria Giulia Mosconi, Maria Khan, Matías Alet, Radhika Lotlikar, Alicia Richardson, Bogdan Ciopleiaș, Mirjam R. Heldner, Susanna M. Zuurbier, Emily Ramage, Selam Kifelew, Vasileios Lioutas, Marika Demers, Marina Charalambous, Dorcas B.C. Gandhi, Urvashy Gopaul, Leonardo Augusto Carbonera, Ralph Kwame Akyea, Ladius Rudovick, Bahati Wajanga, Semvua B. Kilonzo, Robert N. Peck, Mohamed Mnacho, Faraja Chiwanga, Brighton Mushengezi, Kigocha Okeng'o, Henrika Kimambo, Akili Mawazo, Mohamed Manji, Tumaini Nagu, Paschal Ruggajo, William Matuja, Louise Johnson, Octávio Marques Pontes‐Neto, Craig S. Anderson, Sheila Cristina Ouriques Martins · 发表于：Cerebrovascular Diseases Extra · 年份：2025 · DOI：10.1159/000545954 · 被引用次数：7 · 研究领域：Acute Ischemic Stroke Management、Cardiac Arrest and Resuscitation、Dysphagia Assessment and Management

INTRODUCTION: Stroke is a leading cause of morbidity and mortality globally, with Africa bearing a disproportionately high burden of poor outcomes. In sub-Saharan Africa, acute stroke care remains inconsistent, with organized stroke units being either absent or rarely available, contributing to the high stroke mortality rates in the region. To address this issue, the Tanzania Stroke Project (TSP) was launched, aimed at establishing acute stroke services at two of the largest tertiary care centers in collaboration with the Tanzanian Ministry of Health, the World Stroke Organization, and Hospital Directorates. METHODS: TSP utilized a three-tier implementation approach to establish a more organized stroke care system in two large academic hospitals. Here, we detail the process of this initiative, which took place between August 2023 and August 2024. The three-tier approach included (1) the establishment of stroke registries; (2) the training of healthcare workers (HCWs); and (3) the development of acute stroke protocols and establishment of stroke units at Muhimbili National Hospital-Mloganzila and Bugando Medical Center in Tanzania. RESULTS: In tier one (stroke registry), two comprehensive stroke registries were established, including 460 adults (mean age 60 ± 15 years). Hemorrhagic stroke was the most common subtype, accounting for 59% of cases (n = 269). Premorbid hypertension was the most prevalent risk factor, affecting 81% (n = 373) of the patients. More than half of patie...