Improving Stroke Management through Specialized Stroke Units in Nigeria: A situational Review

Abstract

Background: Stroke therapy is aimed at re-opening blocked arteries and increasing the survival of cells that are injured in addition to the early rehabilitation of the stroke patient. The establishment of stroke units has been found to improve the survival of patients and significantly reduce disability by rendering holistic care. Early intervention to rapidly restore and maintain blood supply to the ischemic area in the brain, minimize brain damage and hence impairment as well as disability and secondary complications which will reduce the risk of death is more likely achievable in specialized care settings. The objective of this review is to discuss the role and feasibility of implementing stroke care in specialized stroke units
(SSUs).
Methods: Key literature detailing the care of stroke patients at the different tier of health institutions in Nigeria and abroad were reviewed using Medline and Google search utilizing the following keywords' Stroke
unit; Management; Shared Burden and Nigeria. The difficulties associated with the provision of care for stroke patients in specialized stroke units were identified while the implications and suggestions for the development of such units in Nigeria are addressed.
Results: The care of stroke patients remains mainly uncoordinated and usually managed in the general medical wards with suboptimal management. Issues that may affect establishment of specialized Stroke Unit include lack of Neurologists, Geriatricians with special interest in stroke management, allied health professionals and Nurses trained in providing supportive care. The challenges of the start –up cost, and public education in seeking help early enough are also highlighted.
Conclusion: The evidence for the need for change from the usual care of stroke patient's in general medical wards to specialized stroke units is undisputable. Establishment of such units in Nigeria is desirable, urgent and feasible. The establishment of these SSUs can be started by having specific designated beds in a section of the medical wards with the care assigned to specially trained medical and allied health providers.

Key Words: Sharing; burden; stroke unit; Nigeria.