Fighting Against Stroke in Latin America: A Joint Effort of Medical Professional Societies and Governments
Journal
Frontiers in Neurology
ISSN
1664-2295
Date Issued
2021
Author(s)
Sheila Cristina Ouriques Martins
Thaís Leite Secchi
Michael Brainin
Sebastian Ameriso
Fernando Gongora-Rivera
Claudio Sacks
Carlos Cantú-Brito
Tony Fabian Alvarez Guzman
Germán Enrique Pérez-Romero
Mario Muñoz Collazos
Miguel A. Barboza
Antonio Arauz
Carlos Abanto Argomedo
Nelson Novarro-Escudero
Hector Ignacio Amorin Costabile
Roberto Crosa
Claudia Camejo
Ricardo Mernes
Nelson Maldonado
Daissy Liliana Mora Cuervo
Octávio Marques Pontes Neto
Gisele Sampaio Silva
Leonardo Augusto Carbonera
Ana Claudia de Souza
Eduardo David Gomes de Sousa
Alan Flores
Donoban Melgarejo
Irving R. Santos Carquin
João José Freitas de Carvalho
Francisco Mont'Alverne
Pablo Amaya
Hernan Bayona
Juan Carlos Duran
Victor C. Urrutia
Denizar Vianna Araujo
Valery L. Feigin
Raul G. Nogueira
Type
Resource Types::text::journal::journal article
URL Institutional Repository
Abstract
<jats:p><jats:bold>Introduction:</jats:bold> Stroke is one of the leading causes of death in Latin America, a region with countless gaps to be addressed to decrease its burden. In 2018, at the first Latin American Stroke Ministerial Meeting, stroke physician and healthcare manager representatives from 13 countries signed the Declaration of Gramado with the priorities to improve the region, with the commitment to implement all evidence-based strategies for stroke care. The second meeting in March 2020 reviewed the achievements in 2 years and discussed new objectives. This paper will review the 2-year advances and future plans of the Latin American alliance for stroke.</jats:p><jats:p><jats:bold>Method:</jats:bold> In March 2020, a survey based on the Declaration of Gramado items was sent to the neurologists participants of the Stroke Ministerial Meetings. The results were confirmed with representatives of the Ministries of Health and leaders from the countries at the second Latin American Stroke Ministerial Meeting.</jats:p><jats:p><jats:bold>Results:</jats:bold> In 2 years, public stroke awareness initiatives increased from 25 to 75% of countries. All countries have started programs to encourage physical activity, and there has been an increase in the number of countries that implement, at least partially, strategies to identify and treat hypertension, diabetes, and lifestyle risk factors. Programs to identify and treat dyslipidemia and atrial fibrillation still remained poor. The number of stroke centers increased from 322 to 448, all of them providing intravenous thrombolysis, with an increase in countries with stroke units. All countries have mechanical thrombectomy, but mostly restricted to a few private hospitals. Pre-hospital organization remains limited. The utilization of telemedicine has increased but is restricted to a few hospitals and is not widely available throughout the country. Patients have late, if any, access to rehabilitation after hospital discharge.</jats:p><jats:p><jats:bold>Conclusion:</jats:bold> The initiative to collaborate, exchange experiences, and unite societies and governments to improve stroke care in Latin America has yielded good results. Important advances have been made in the region in terms of increasing the number of acute stroke care services, implementing reperfusion treatments and creating programs for the detection and treatment of risk factors. We hope that this approach can reduce inequalities in stroke care in Latin America and serves as a model for other under-resourced environments.</jats:p>
Subjects
latin america
;
stroke
;
stroke centers
;
stroke system of care
;
stroke units
;
article
;
atrial fibrillation
;
awareness
;
blood clot lysis
;
cerebrovascular accident
;
diabetes mellitus
;
dyslipidemia
;
government
;
health care system
;
hospital discharge
;
human
;
hypertension
;
lifestyle
;
medical profession
;
physical activity
;
risk factor
;
south and central america
;
telemedicine