SynthesisAnnals of clinical and translational neurology2022
Younger age of stroke in low-middle income countries is related to healthcare access and quality.
Synthesis in Annals of clinical and translational neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 3 of them syntheses that pooled it.
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Who cites it
36 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Global Pediatric Stroke Epidemiology: A Systematic Review of the Literature and Meta-Analysis.Journal of child neurology · 2026Pooled it
- Post-traumatic growth in young and middle-aged patients with stroke: a qualitative systematic review and meta-synthesis.BMC psychology · 2025Pooled it
- Stroke epidemiology and outcomes of stroke patients in Nepal: a systematic review and meta-analysis.BMC neurology · 2023Pooled it
- Awareness and perception of the traditional methods of stroke management among stroke survivors in selected health facilities and traditional centers: a mixed method study.BMC complementary medicine and therapies · 2026Article
- Article
- Predictors of in-hospital case-fatality in patients with stroke at the National Hospital of the Kyrgyz Republic: a retrospective cohort study.BMC neurology · 2026Article
- Rare coding variation and stroke heterogeneity in Saudi Arabia: an exome‑wide association study across severity, etiology, vascular territory, and early‑onset disease.BMC neurology · 2026Article
- Barriers to thrombolysis in acute ischaemic stroke: an epidemiological review from a tertiary hospital in the Eastern Cape, South Africa.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2026Article
- Sex Disparities in Prehospital and In-Hospital Delays to Intravenous Thrombolysis in Egyptian Stroke Patients.Neuroepidemiology · 2026Article
- Global research trends and emerging frontiers in young-onset stroke: a bibliometric analysis (1996-2026).Frontiers in neurology · 2026Review
- The Quindío stroke network: impact of an integrated care model on mortality and functional outcomes in a middle-income country.Frontiers in stroke · 2026Article
- Rising stroke burden in Uganda: A national time-series analysis and forecasts, 2016-2028.PloS one · 2026Article
- Health-seeking behaviour, health service delivery and its perceived impact among stroke survivors in Sierra Leone: a longitudinal qualitative study embedded in the SISLE project.BMC health services research · 2025Article
- Longitudinal trends in stroke risk factors and mortality over 20 years from a central stroke referral center in Pakistan using clinically digitized data.eNeurologicalSci · 2025Article
- Public Awareness of Stroke Symptoms in Developed and Developing Countries: A Systematic Review.Journal of caring sciences · 2025Review
- Barriers and facilitators to accessing stroke care services in Tanzania: an explorative qualitative study among stroke survivors, caregivers and healthcare providers.BMC health services research · 2025Article
- Clinical profile of adult stroke patients in Angola: a cross-sectional study.Scientific reports · 2025Article
- The impact of chronic kidney disease on prognosis in acute stroke: unraveling the pathophysiology and clinical complexity for optimal management.Clinical and experimental nephrology · 2025Review
- Elevated cardiovascular risk factors and chronic disease mortality in the Caribbean: A Cross-Sectional Study.PLOS global public health · 2025Article
- Stroke in young adults in the Middle East and North Africa region: What is the difference from elsewhere? A report from sixteen centers experiences.Frontiers in neurology · 2025Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
Stroke is the second leading cause of mortality globally with higher burden and younger age in low-middle income countries (LMICs) than high-income countries (HICs). However, it is unclear to what extent differences in healthcare access and quality (HAQ) and prevalence of risk factors between LMICs and HICs contribute to younger age of stroke in LMICs. In this systematic review, we conducted meta-analysis of 67 articles and compared the mean age of stroke between LMICs and HICs, before and after adjusting for HAQ index. We also compared the prevalence of main stroke risk factors between HICs and LMICs. The unadjusted mean age of stroke in LMICs was significantly lower than HICs (63.1 vs. 68.6), regardless of gender (63.9 vs. 66.6 among men, and 65.6 vs. 70.7 among women) and whether data were collected in population- (64.7 vs. 69.5) or hospital-based (62.6 vs. 65.9) studies (all p < 0.01). However, after adjusting for HAQ index, the difference in the mean age of stroke between LMICs and HICs was not significant (p ≥ 0.10), except among women (p = 0.048). In addition, while the median prevalence of hypertension in LMICs was 23.4% higher than HICs, the prevalence of all other risk factors was lower in LMICs than HICs. Our findings suggest a much larger contribution of HAQ to the younger mean age of stroke in LMICs, as compared with other potential factors. Additional studies on stroke care quality and accessibility are needed in LMICs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.