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Najmi I, Idrissi SJ, Bensouda K, Marzouki Z, Dinia M, Talbi I, Benmaamar S, Bouchal S, El Fakir S, El Rhazi K, Fihri OF, Belahsen MF. [Thrombolysis alert in ischemic stroke: experience of the international private clinic Al Badie in Fez (cross-sectional study of 60 cases)]. Pan Afr Med J 2024; 47:167. [PMID: 39036032 PMCID: PMC11260060 DOI: 10.11604/pamj.2024.47.167.42376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 01/22/2024] [Indexed: 07/23/2024] Open
Abstract
Intravenous thrombolysis is the standard treatment for acute ischemic stroke. We here report the cases of thrombolysis alert in the private sector in Morocco We conducted a prospective study of all patients with neurological deficit of sudden onset occurred within the first 12 hours admitted to the Emergency Department of the Al Badie international private clinic from January 2022 to September 2023. Epidemiological, clinical and etiological characteristics as well as data on outpatient and inpatient delays were collected. Sixty patients were included in the study. The average admission delay was 198.36 ± 79.23 minutes. The mean NIHSS (National Institutes of Health Stroke Scale) score was 10.41 ± 4.97. The average time for imaging was 26.68 ± 9.63 minutes. Ischaemic stroke was the most common diagnosis (85%), followed by "stroke mimics" (11.6%). Thirteen patients underwent thrombolysis with tenecteplase. The mean time from admission to the initiation of thrombolysis was 107.15 ± 24.48 minutes. Follow-up imaging at 24 hours post thrombolysis revealed symptomatic haemorrhagic transformation in 3 patients. Six patients were transferred to the Hassan II University Hospital for thrombolysis and/or mechanical thrombectomy. After 3 months, 4 patients were autonomous (Rankin score changed between 0 and 2). Our experience shows that it is imperative to reduce outpatient and inpatient delays in treatment in order to increase the proportion of patients treated with thrombolysis.
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Affiliation(s)
- Imane Najmi
- Unité Neurovasculaire, Clinique Internationale Al Badie, 355 Lotissement Jardins El Badie, Ain Chkf, 30000 Fès, Maroc
| | | | - Khadija Bensouda
- Service des Urgences, Clinique Internationale Al Badie, Fès, Maroc
| | - Zineb Marzouki
- Service de Radiologie, Clinique Internationale Al Badie, Fès, Maroc
| | - Mohammed Dinia
- Service de Cardiologie et de Cardiologie Interventionnelle, Clinique Internationale Al Badie, Fès, Maroc
| | - Ilyass Talbi
- Service de Réanimation, Clinique Internationale Al Badie, Fès, Maroc
| | - Soumaya Benmaamar
- Laboratoire d'Epidémiologie, Recherche Clinique et Science Communautaire, Faculté de Médecine et de Pharmacie, Université Sidi Mohamed Ben Abdellah, Fès, Maroc
| | - Siham Bouchal
- Service de Neurologie, Centre Hospitalier Universitaire Hassan II Fès, Fès, Maroc
| | - Samira El Fakir
- Laboratoire d'Epidémiologie, Recherche Clinique et Science Communautaire, Faculté de Médecine et de Pharmacie, Université Sidi Mohamed Ben Abdellah, Fès, Maroc
| | - Karima El Rhazi
- Laboratoire d'Epidémiologie, Recherche Clinique et Science Communautaire, Faculté de Médecine et de Pharmacie, Université Sidi Mohamed Ben Abdellah, Fès, Maroc
| | - Oussama Fassi Fihri
- Service de Cardiologie et de Cardiologie Interventionnelle, Clinique Internationale Al Badie, Fès, Maroc
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Malaeb D, Hallit S, Sakr F, Dabbous M, Saadeh W, Mansour S, Cherri S, Sarayeldyine SA, Salameh P, Hosseini H. The use of intravenous thrombolytics in acute ischemic stroke management: A scoping review from 2008 till 2021 in the Arab world in the Middle East and North Africa. J Stroke Cerebrovasc Dis 2023; 32:107201. [PMID: 37290154 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/09/2023] [Accepted: 05/25/2023] [Indexed: 06/10/2023] Open
Abstract
OBJECTIVE The aim of this review was to assess and analyze the research output on intravenous thrombolysis in acute ischemic stroke in the Arab world in the Middle East and North Africa. METHODS Published literature on intravenous thrombolysis for acute ischemic stroke from 2008 to 2021 were retrieved from several electronic databases. Extracted records were analyzed in terms of year of publication, country, journal, research area, authors, and organizational affiliations. RESULTS A total of 37 studies were published between 2008 and 2021 from different Arab countries. Eight studies assessed the safety and efficacy of thrombolytic agents in AIS. Three studies were KAP studies addressing the knowledge, attitude and practice towards IVT. The majority of the selected studies (n=16) discussed the utilization rate of IVT among patients in different hospital settings across these countries. Ten studies reported the outcomes associated with the use of IVT for AIS. CONCLUSION This is the first scoping review to study the research activity related to the use of IVT in stroke in the Arab nations. In the last 15 years, stroke research productivity was very low in the Arab world compared to other regions of the world due to several impeding factors. Given the high burden of in-adherence to acute stroke treatment in the Arab nations, there is a serious need for an increased high-quality research activity to highlight the roadblocks associated with the limited use of IVT.
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Affiliation(s)
- Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates; School of Pharmacy, Lebanese International University, Beirut, Lebanon.
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), P.O Box: 446, Jounieh lebanon; Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon; Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Fouad Sakr
- School of Pharmacy, Lebanese International University, Beirut, Lebanon; INSPECT-LB (Institut National de Sant e Publique, d'Épid emiologie Clinique et de Toxicologie-Liban); UMR U955 INSERM, Institut Mondor de Recherche Biomédicale, Université Paris-Est Créteil, 94010 Créteil, France; École Doctorale Sciences de la Vie et de la Santé, Université Paris-Est Créteil, 94010 Créteil, France
| | - Mariam Dabbous
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Wadih Saadeh
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon; Faculty of Public health, Lebanese University, Fanar, Lebanon
| | - Sara Mansour
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Sarah Cherri
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | | | - Pascale Salameh
- INSPECT-LB (Institut National de Sant e Publique, d'Épid emiologie Clinique et de Toxicologie-Liban); Faculty of Pharmacy, Lebanese University, Beirut, Lebanon; Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus; School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Hassan Hosseini
- INSERM U955-E01, IMRB, Henri Mondor Hospital, Créteil, France; Department of Neurology, Henri Mondor Hospital, AP-HP, Créteil, France
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Omari M, Maiouak M, Bahra N, El Harch I, Youbi M, Belakhel L, Abousselham L, Otmani N, Mohammed Faouzi B, Tachfouti N. Direct Healthcare Cost of Ischemic Stroke Management in Morocco. Cureus 2023; 15:e42180. [PMID: 37602017 PMCID: PMC10439518 DOI: 10.7759/cureus.42180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2023] [Indexed: 08/22/2023] Open
Abstract
BACKGROUND Strokes are a group of heterogeneous conditions that can cause lasting brain damage, long-term disability, or even death. In Morocco, the management of this disease generates important expenses and increases the financial burden on health care. In order to rationalize the expenses and to direct the budgetary policy in healthcare, we aimed to estimate the cost of ischemic stroke (IS) management in Morocco through this study. METHODS A cost-of-illness study was conducted between March 2018 and March 2019 at the neurology department of the Hassan II University Hospital, Fez. We included all patients who were admitted, during this period, to the department for IS. The collected data included sociodemographic information, and all details regarding the patient's medical management (diagnosis, treatment, etc.). The cost was estimated using a "bottom-up micro-costing" approach with a societal perspective. RESULTS A total of 267 individuals were included in this study with a female predominance (56.6%); the mean age was 66.93 ± 14.83 years. The total cost of ischemic stroke management per patient per year was estimated at $3674.32 ± 1340.81, with a high share related to hospitalization at $1415.06 ± 1015.53. A statistically significant association was found between total cost and age (p=0.014), National Institutes of Health Stroke Scale (NIHSS) score (p≤0.001), and length of hospitalization (p≤0.001); however, no association was found with other factors (sex, complication, Rankin score, etc.). CONCLUSION Ischemic strokes are relatively frequent in Morocco. Their management generates an important cost, which is influenced by several factors such as severity of the disease and the duration of hospitalization. This cost can be decreased by rationalizing the expenses and acting on various risk factors of ischemic strokes.
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Affiliation(s)
- Mohammed Omari
- Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
| | - Moncef Maiouak
- Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
| | - Nassiba Bahra
- Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
| | - Ibtissam El Harch
- Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
| | - Mohammed Youbi
- Department of Epidemiology and Disease Control, Ministry of Health and Social Protection, Rabat, MAR
| | - Latifa Belakhel
- Department of Epidemiology and Disease Control, Ministry of Health and Social Protection, Rabat, MAR
| | - Loubna Abousselham
- Department of Epidemiology and Disease Control, Ministry of Health and Social Protection, Rabat, MAR
| | - Nada Otmani
- Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
| | | | - Nabil Tachfouti
- Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
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Zhao Y, Han Y, Sun W, Zhang Y. Clinical Symptoms, Etiology and Prognosis of Acute Bilateral Posterior Circulation Cerebral Infarction. Int J Gen Med 2022; 15:2787-2793. [PMID: 35300144 PMCID: PMC8922039 DOI: 10.2147/ijgm.s351560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 02/21/2022] [Indexed: 11/23/2022] Open
Abstract
Background Acute BPCCI was previously presented only as a case report. The prognosis of acute BPCCI is related to many factors, such as gender, age, NIHSS, Hypertension and so on. We first systematically analyzed the clinical symptoms, imaging, etiology and prognosis of acute BPCCI and identified a statistically significant factor. Methods A total of 72 acute BPCCI patients admitted to the Department of Neurology, Beijing Friendship hospital, Capital Medical University were included. The demographics, risk factors, clinical manifestations, National Institute of Health stroke scale (NIHSS) on admission, imaging findings, and the modified Rankin Scale (mRS) at the third month after onset were collected. The mRS score greater than 3 indicated poor prognosis. The factors affecting their prognosis were analyzed. Results We included 72 Chinese patients with acute BPCCI (82% male). The most common symptoms and signs of the patients were dizziness and unilateral limb weakness. Patients with acute BPCCI involving cerebellum accounted for 85% of the patients. The number of patients with large-artery atherosclerosis was 46 (64%), the number of patients with cardiogenic embolism was 12 (17%), and the number of patients with other causes and unknown causes was 14 (19%). After multivariate regression analyses, NIHSS score (odds ratio 0.725, 95% confidence interval 0.586–0.896, P = 0.003) was closely related with the prognosis of acute BPCCI. Conclusion Our study found that the symptoms and signs of acute BPCCI were nonspecific and mainly depended on imaging diagnosis. Acute BPCCI involving cerebellum was the most common case of acute BPCCI. The main cause of acute BPCCI was large-artery atherosclerosis. NIHSS score is identified as a statistically significant factor. The higher NIHSS score on admission showed the worse prognosis. Therefore, an acute BPCCI patient with a high NIHSS score should be paid more attention at the time of diagnosis.
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Affiliation(s)
- Yuan Zhao
- Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Yanfei Han
- Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Weidong Sun
- Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Yongbo Zhang
- Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China
- Correspondence: Yongbo Zhang, Tel +86 10-63139807, Email
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Marcus ME, Ebert C, Geldsetzer P, Theilmann M, Bicaba BW, Andall-Brereton G, Bovet P, Farzadfar F, Singh Gurung M, Houehanou C, Malekpour MR, Martins JS, Moghaddam SS, Mohammadi E, Norov B, Quesnel-Crooks S, Wong-McClure R, Davies JI, Hlatky MA, Atun R, Bärnighausen TW, Jaacks LM, Manne-Goehler J, Vollmer S. Unmet need for hypercholesterolemia care in 35 low- and middle-income countries: A cross-sectional study of nationally representative surveys. PLoS Med 2021; 18:e1003841. [PMID: 34695124 PMCID: PMC8575312 DOI: 10.1371/journal.pmed.1003841] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 11/08/2021] [Accepted: 10/08/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND As the prevalence of hypercholesterolemia is increasing in low- and middle-income countries (LMICs), detailed evidence is urgently needed to guide the response of health systems to this epidemic. This study sought to quantify unmet need for hypercholesterolemia care among adults in 35 LMICs. METHODS AND FINDINGS We pooled individual-level data from 129,040 respondents aged 15 years and older from 35 nationally representative surveys conducted between 2009 and 2018. Hypercholesterolemia care was quantified using cascade of care analyses in the pooled sample and by region, country income group, and country. Hypercholesterolemia was defined as (i) total cholesterol (TC) ≥240 mg/dL or self-reported lipid-lowering medication use and, alternatively, as (ii) low-density lipoprotein cholesterol (LDL-C) ≥160 mg/dL or self-reported lipid-lowering medication use. Stages of the care cascade for hypercholesterolemia were defined as follows: screened (prior to the survey), aware of diagnosis, treated (lifestyle advice and/or medication), and controlled (TC <200 mg/dL or LDL-C <130 mg/dL). We further estimated how age, sex, education, body mass index (BMI), current smoking, having diabetes, and having hypertension are associated with cascade progression using modified Poisson regression models with survey fixed effects. High TC prevalence was 7.1% (95% CI: 6.8% to 7.4%), and high LDL-C prevalence was 7.5% (95% CI: 7.1% to 7.9%). The cascade analysis showed that 43% (95% CI: 40% to 45%) of study participants with high TC and 47% (95% CI: 44% to 50%) with high LDL-C ever had their cholesterol measured prior to the survey. About 31% (95% CI: 29% to 33%) and 36% (95% CI: 33% to 38%) were aware of their diagnosis; 29% (95% CI: 28% to 31%) and 33% (95% CI: 31% to 36%) were treated; 7% (95% CI: 6% to 9%) and 19% (95% CI: 18% to 21%) were controlled. We found substantial heterogeneity in cascade performance across countries and higher performances in upper-middle-income countries and the Eastern Mediterranean, Europe, and Americas. Lipid screening was significantly associated with older age, female sex, higher education, higher BMI, comorbid diagnosis of diabetes, and comorbid diagnosis of hypertension. Awareness of diagnosis was significantly associated with older age, higher BMI, comorbid diagnosis of diabetes, and comorbid diagnosis of hypertension. Lastly, treatment of hypercholesterolemia was significantly associated with comorbid hypertension and diabetes, and control of lipid measures with comorbid diabetes. The main limitations of this study are a potential recall bias in self-reported information on received health services as well as diminished comparability due to varying survey years and varying lipid guideline application across country and clinical settings. CONCLUSIONS Cascade performance was poor across all stages, indicating large unmet need for hypercholesterolemia care in this sample of LMICs-calling for greater policy and research attention toward this cardiovascular disease (CVD) risk factor and highlighting opportunities for improved prevention of CVD.
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Affiliation(s)
- Maja E. Marcus
- Department of Economics & Centre for Modern Indian Studies, University of Goettingen, Göttingen, Germany
| | - Cara Ebert
- RWI-Leibniz Institute for Economic Research, Essen (Berlin Office), Germany
| | - Pascal Geldsetzer
- Division of Primary Care and Population Health, Department of Medicine, Stanford University, Stanford, California, United States of America
- Heidelberg Institute of Global Health, Heidelberg University and University Hospital, Heidelberg, Germany
| | - Michaela Theilmann
- Heidelberg Institute of Global Health, Heidelberg University and University Hospital, Heidelberg, Germany
| | | | | | - Pascal Bovet
- Ministry of Health, Victoria, Seychelles
- University Centre for General Medicine and Public Health (Unisanté), Lausanne, Switzerland
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Corine Houehanou
- Laboratory of Epidemiology of Chronic and Neurological Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Abomey-Calavi, Benin
| | - Mohammad-Reza Malekpour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Joao S. Martins
- Faculty of Medicine and Health Sciences, Universidade Nacional Timor Lorosa’e, Dili, Timor-Leste
| | - Sahar Saeedi Moghaddam
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Mohammadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bolormaa Norov
- National Center for Public Health, Ulaanbaatar, Mongolia
| | | | - Roy Wong-McClure
- Office of Epidemiology and Surveillance, Caja Costarricense de Seguro Social, San Jose, Costa Rica
| | - Justine I. Davies
- Institute for Applied Health Sciences, University of Birmingham, Birmingham, United Kingdom
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of Witwatersrand, Johannesburg, South Africa
- Centre for Global Surgery, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Mark A. Hlatky
- Department of Medicine, Stanford University, Stanford, California, United States of America
| | - Rifat Atun
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Till W. Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University and University Hospital, Heidelberg, Germany
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Africa Health Research Institute, Somkhele, South Africa
| | - Lindsay M. Jaacks
- Global Academy of Agriculture and Food Security, University of Edinburgh, Edinburgh, United Kingdom
- Public Health Foundation of India, New Delhi, Delhi NCR, India
| | - Jennifer Manne-Goehler
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Sebastian Vollmer
- Department of Economics & Centre for Modern Indian Studies, University of Goettingen, Göttingen, Germany
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Kharbach A, Obtel M, Achbani A, Aasfara J, Hassouni K, Lahlou L, Razine R. Ischemic stroke in Morocco: Prehospital delay and associated factors. Rev Epidemiol Sante Publique 2021; 69:345-359. [PMID: 34148762 DOI: 10.1016/j.respe.2021.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/28/2021] [Accepted: 03/30/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES This study aimed to estimate prehospital delay and to identify the factors associated with the late arrival of patients with ischemic stroke at the Souss Massa Regional Hospital Center in Morocco. PATIENTS AND METHODS An observational, prospective, cross-sectional study was conducted from March 2019 to September 2019 in the Souss Massa regional hospital center, which is a public hospital structure. A questionnaire was administered to patients with ischemic stroke and to bystanders (family or others), while clinical and paraclinical data were collected from medical records. Univariate and multivariate logistic regression analyses were used to identify the factors associated with delayed arrival at emergency department. RESULTS A total of 197 patients and 197 bystanders who fulfilled the criteria for the study were included. The median time from symptom onset to hospital arrival was 6hours (IQR, 4-16). Multiple regression analysis showed that illiteracy (OR 38.58; CI95%: 3.40-437.27), waiting for symptoms to disappear (patient behavior) (OR 11.24; CI95%: 1.57-80.45), deciding to go directly to the hospital (patient behavior) (OR 0.07; CI95%: 0.01-0.57), bystander's knowledge that stroke is a disease requiring urgent care within a limited therapeutic window (OR 0.005; CI95%: 0.00-0.36), and direct admission without reference (OR 0.005; CI95%: 0.00-0.07), were independently associated with late arrival (>4.5hours) of patients with acute ischemic stroke. In addition, illiteracy (OR 24.62; CI95%: 4.37-138.69), vertigo and disturbance of balance or coordination (OR 0.14; CI95%: 0.03-0.73), the relative's knowledge that stroke is a disease requiring urgent care and within a limited therapeutic window (OR 0.03; CI95%: 0.00-0.22), calling for an ambulance (relative's behavior) (OR 0.16; CI95%: 0.03-0.80), distance between 50 and 100km (OR 10.16; CI95%: 1.16-89.33), and direct admission without reference (OR 0.03; CI95%: 0.00-0.14), were independently associated with late arrival (>6hours) of patients with acute ischemic stroke. CONCLUSION Patient behavior, bystander knowledge and direct admission to the competent hospital for stroke care are modifiable factors potentially useful for reducing onset-to-door time, and thereby increasing the implementation rates of acute stroke therapies.
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Affiliation(s)
- A Kharbach
- Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy of Rabat, Mohammed V University of Rabat, Rabat, Morocco.
| | - M Obtel
- Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy of Rabat, Mohammed V University of Rabat, Rabat, Morocco; Laboratory of Social Medicine (Public Health, Hygiene and Preventive Medicine), Faculty of Medicine and Pharmacy of Rabat, Mohammed V University of Rabat, Rabat, Morocco.
| | - A Achbani
- Laboratory of Cell Biology and Molecular Genetics (LBCGM), Department of Biology, Faculty of Sciences, University Ibn Zohr Agadir, Rabat, Morocco.
| | - J Aasfara
- Department of Neurology, International Cheikh Khalifa University Hospital, Mohammed VI University of Health Sciences (UM6SS) Casablanca, Rabat, Morocco.
| | - K Hassouni
- International School of Public Health, Mohammed VI University of Health Sciences (UM6SS) Casablanca, Rabat, Morocco.
| | - L Lahlou
- Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy of Rabat, Mohammed V University of Rabat, Rabat, Morocco; Faculty of Medicine and Pharmacy of Agadir, University Ibn Zohr, Agadir, Morocco.
| | - R Razine
- Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy of Rabat, Mohammed V University of Rabat, Rabat, Morocco; Laboratory of Social Medicine (Public Health, Hygiene and Preventive Medicine), Faculty of Medicine and Pharmacy of Rabat, Mohammed V University of Rabat, Rabat, Morocco.
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Arabambi B, Oshinaike O, Akilo O, Yusuf Y, Ogun S. Pattern, risk factors, and outcome of acute stroke in a Nigerian university teaching hospital: A 1-year review. NIGERIAN JOURNAL OF MEDICINE 2021. [DOI: 10.4103/njm.njm_8_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Level of Knowledge on Stroke and Associated Factors: A Cross-Sectional Study at Primary Health Care Centers in Morocco. Ann Glob Health 2020; 86:83. [PMID: 32742941 PMCID: PMC7380055 DOI: 10.5334/aogh.2885] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background: Stroke is increasingly becoming a major cause of disability and mortality. However, it can be prevented by raising awareness about risk factors and early health care management of patients. Objective: The aim of this study is to assess the level of knowledge on stroke, its risk factors, and warning signs in the population attending urban primary health care centers in the city of Agadir, Morocco. Methods: This is a multicentric cross-sectional study with a descriptive and analytical purpose. The study was conducted at five urban primary health care centers in Agadir in centralwest Morocco. All persons over the age of 18 years who consulted the health centers and who agreed to fill in the questionnaire were recruited, except for the foreign population and health workers. An interview questionnaire was used to assess the level of knowledge on stroke. Findings: A total of 469 participants were involved in the study. The median knowledge score was 8 (Interquartile range 4–13). High blood pressure (55.7%), depression and stress (48.8%) were the most well-known risk factors. Sudden weakness of the face, arms or legs (37.3%) was the main warning sign cited by the participants. Multivariate analysis revealed that illiteracy (OR 1.92; CI95%: 1.08–3.44) primary education (OR 3.43; CI95%: 1.63–7.21), rural residential (OR 1.67; CI95%: 1.07–2.59), no history of stroke among respondents (OR 16.41; CI95%: 4.37–61.59) and no history of stroke among relatives, acquaintances, or neighbors (OR 4.42; CI95%: 2.81–6.96), were independently associated with a lower level of knowledge of stroke (Table 4). Conclusions: The low level of knowledge on stroke among this Moroccan population indicates the importance of implementing stroke education initiatives in the community. More specifically, proximity education and awareness programs ought to be considered to anchor lifestyle preventive behaviors along with appropriate and urgent actions regarding the warning signs of stroke.
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