Stroke and thrombolysis in developing countries.
BACKGROUND
Over the past few decades, the burden of stroke in developing countries has grown to epidemic proportions. Two-thirds of global stroke occurs in low- and middle-income countries. We have found that little information is obtainable concerning the availability of thrombolysis therapy in developing countries.


RESULTS
The epidemiology of stroke is well investigated in the developed world; however, in the developing world stroke is less well documented. Most of the available stroke data from these countries are hospital-based. Stroke thrombolysis is currently used in few developing countries like Brazil, Argentina, Senegal, Iran, Pakistan, China, Thailand, and India. The two main barriers for implementation of thrombolysis therapy in developing countries are the high cost of tissue plasminogen activator and lack of proper infrastructure. Most of the centers with the infrastructure to deliver thrombolysis for stroke are predominantly private sector, and only available in urban areas.


CONCLUSIONS
Until a more cost-effective thrombolytic agent and the proper infrastructure for widespread use of thrombolysis therapy are available, developing nations should focus on primary and secondary stroke prevention strategies and the establishment of stroke units wherever possible. Such multi-faceted approaches will be more cost-effective for developing countries than the use of thrombolysis.
Durai Pandian
Jeyaraj
J
Department of Neurology, Christian Medical College, Ludhiana, Punjab, India. jeyarajpandian@yahoo.co.in
Padma
Vasantha
V
Vijaya
Pamidimukkala
P
Sylaja
P N
PN
Murthy
Jagaralpudi M K
JM
D017281:Cost of Illness; D003906:Developing Countries; D005343:Fibrinolytic Agents / Q000191:economics / Q000627:therapeutic use; D006757:Hospital Units; D006801:Humans; D020521:Stroke / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology*; D015912:Thrombolytic Therapy / Q000191:economics
D005343:Fibrinolytic Agents