Fighting Against Stroke in Latin America: A Joint Effort of Medical Professional Societies and Governments

Introduction: 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 Decl...

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Published in:	Frontiers in neurology Vol. 12; p. 743732
Main Authors:	Martins, Sheila Cristina Ouriques, Lavados, Pablo, Secchi, Thaís Leite, Brainin, Michael, Ameriso, Sebastian, Gongora-Rivera, Fernando, Sacks, Claudio, Cantú-Brito, Carlos, Alvarez Guzman, Tony Fabian, Pérez-Romero, Germán Enrique, Muñoz Collazos, Mario, Barboza, Miguel A., Arauz, Antonio, Abanto Argomedo, Carlos, Novarro-Escudero, Nelson, Amorin Costabile, Hector Ignacio, Crosa, Roberto, Camejo, Claudia, Mernes, Ricardo, Maldonado, Nelson, Mora Cuervo, Daissy Liliana, Pontes Neto, Octávio Marques, Silva, Gisele Sampaio, Carbonera, Leonardo Augusto, Souza, Ana Claudia de, Sousa, Eduardo David Gomes de, Flores, Alan, Melgarejo, Donoban, Santos Carquin, Irving R., Hoppe, Arnold, Carvalho, João José Freitas de, Mont'Alverne, Francisco, Amaya, Pablo, Bayona, Hernan, Navia González, Victor Hugo, Duran, Juan Carlos, Urrutia, Victor C., Araujo, Denizar Vianna, Feigin, Valery L., Nogueira, Raul G.
Format:	Journal Article
Language:	English
Published:	Frontiers Media S.A 01-10-2021
Subjects:	Latin America Neurology stroke stroke centers stroke system of care stroke units
Online Access:	Get full text
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Summary:	Introduction: 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. Method: 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. Results: 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. Conclusion: 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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Edited by: Simona Sacco, University of L'Aquila, Italy Reviewed by: Anita Ante Arsovska, Saints Cyril and Methodius University of Skopje, North Macedonia; Alexander Tsiskaridze, Tbilisi State University, Georgia This article was submitted to Stroke, a section of the journal Frontiers in Neurology
ISSN:	1664-2295 1664-2295
DOI:	10.3389/fneur.2021.743732