title: Development-assistance Strategies for Stroke in Low- and Middle-income Countries.
abstract: While communicable diseases still pose a serious health threat in developing countries, previously neglected health issues caused by non-communicable diseases such as stroke are rapidly becoming a major burden to these countries. In this review we will discuss the features and current status of stroke in low- and middle-income countries (LMICs). Overall the global burden of hemorrhagic stroke is larger than ischemic stroke, with a disproportionately greater burden, measured in incidence and disability-adjusted life-years, regionally localized in LMICs. Patients in poorer countries suffer due to insufficient primary care needed to control risk factors such as hypertension, and inadequate emergency care systems through which sudden events should be managed. In light of these situations, we emphasize two strategic points for development assistance. First, assistance should be provided for bolstering, integrating, and coordinating both the primary health and emergency care systems, in order to prevent stroke and strengthen stroke management, respectively. Second, the assistance needs to focus on programs at the community level, to reduce life-style risks of stroke in a more sustainable manner, and to improve stroke outcomes more effectively.
authors.affiliation: Department of Neurology, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Hyon
authors.initials: H
authors.lastname: Lee
authors.affiliation: JW Lee Center for Global Medicine, Seoul, Korea. ; Department of Family Medicine, College of Medicine, Seoul National University, Seoul, Korea.
authors.forename: You-Seon
authors.initials: YS
authors.lastname: Nam
authors.affiliation: JW Lee Center for Global Medicine, Seoul, Korea. ; Department of Neurology, College of Medicine, Seoul National University, Seoul, Korea.
authors.forename: Kyoung-Min
authors.initials: KM
authors.lastname: Lee
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration*; D003906:Developing Countries / Q000191:economics*; D057217:Economic Development; D014943:Global Health; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D015994:Incidence; D007391:International Cooperation; D017146:Models, Organizational; D015995:Prevalence; D012307:Risk Factors; D020521:Stroke / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control*
keywords: Cerebrovascular Disorder; Community-based Approach; Emergency Care System; Global Health Burden; Non-communicable Diseases; Primary Health Care