AUTHOR=Al Hashmi Amal. M. , Shuaib Ashfaq , Imam Yahia , Amr Dareen , Humaidan Hani , Al Nidawi Firas , Sarhan Ahmed , Mustafa Wessam , Khalefa Wael , Ramadan Ismail , Usman Fritz Sumantri , Hokmabadi Elyar Sadeghi , Ghorbani Mohammed , Nassir Temeem , Aladham Farid , Salmeen Athari , Kikano Raghid , Muda Sobri , Jose Sachin , Bulushi Manal Al , Sajwani Badrai , Wasay Mohammad , Bashir Qasim , Al Hazzani Adel , Khoja Waleed , Alkadere Radwan , Osman Haytham , Hussein Abbashar , Churojana Anchalee , Hammami Nadia , Ozdemir Atilla Ozcan , Giray Semih , Gurkas Erdem , Hussain Seyd Irteza , Sallam Abdul Rahman , Mansour Ossama Yassin 

TITLE=Stroke services in the Middle East and adjacent region: A survey of 34 hospital-based stroke services

JOURNAL=Frontiers in Neurology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.1016376

DOI=10.3389/fneur.2022.1016376

ISSN=1664-2295

ABSTRACT=Background: Acute stroke care is complex and requires multidisciplinary networking. There is insufficient data on stroke care in the Middle East and adjacent regions in Asia and Africa.  
Objective: Evaluate the state of readiness of stroke programs in the Middle East North Africa and surrounding regions (MENA+) to treat acute stroke.
Method: Online questionnaire survey on the evaluation of stroke care across hospitals in the MENA+ region between April 2021 and January 2022. 
Results: The survey was completed by 34/50 (68%) hospitals. The median population serviced by participating hospitals was 2 million. The median admission of stroke patients/year was 600 (250 - 1100). The median length of stay at the stroke units was 5 days. 34/34(100%) of these hospitals have 24/7 CT head available. 17/34 (50%) have emergency guidelines for prehospital acute stroke care. Mechanical thrombectomy with/without IVT was available in 24/34 (70.6%).  51% was the median (IQR; 15 – 75%) of patients treated with IVT within 60 minutes from arrival. 35 minutes was the median time to reverse warfarin-associated ICH. 
Conclusion: This is the first large study on the availability of resources for the management of acute stroke in the MENA+ region. We noted the disparity in stroke care between high-income and low-income countries. Concerted efforts are required to improve stroke care in low-income countries. Accreditation of stroke programs in the region will be helpful.