Neurocritical Care Organization in the Low-Income and Middle-Income Countries
1
Issued Date
2025-01-01
Resource Type
ISSN
15416933
eISSN
15560961
Scopus ID
2-s2.0-85218836233
Pubmed ID
39920547
Journal Title
Neurocritical Care
Rights Holder(s)
SCOPUS
Bibliographic Citation
Neurocritical Care (2025)
Suggested Citation
Prabhakar H., Lele A.V., Kapoor I., Mahajan C., Shrestha G.S., Rao C.V., Suarez J.I., Livesay S.L., Shafiq F., Popugaev K., Santosa D., Zada O.N., Yang W., Nisha H.A., Mijangos-Mendez J.C., Agaba P.K., Portilla J.L.P., Tuahir Y.H., Shanmugam P., Arruebarrena Y.P., Videtta W., Vásquez-García S., Raheem M.S.A., Yimer F., Padayachy L.C., Naranjo L.S., Arriaga P., Myei C., Matuja S.S., Fadalla T., Viarasilpa T., Lundeg G., Salisu-Kabara H.M., Tsan S.E.H., Gutierrez S.P., Yankae L.P., Konkayev A., Chaikittisilpa N., Sampaio G., Van Bui T., Mariano G.S.L., Sabillon G.A., Blanco P., Ortiz W., Gallardo A.J.L., Arun O., Mani K. Neurocritical Care Organization in the Low-Income and Middle-Income Countries. Neurocritical Care (2025). doi:10.1007/s12028-025-02210-7 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/105542
Title
Neurocritical Care Organization in the Low-Income and Middle-Income Countries
Author(s)
Prabhakar H.
Lele A.V.
Kapoor I.
Mahajan C.
Shrestha G.S.
Rao C.V.
Suarez J.I.
Livesay S.L.
Shafiq F.
Popugaev K.
Santosa D.
Zada O.N.
Yang W.
Nisha H.A.
Mijangos-Mendez J.C.
Agaba P.K.
Portilla J.L.P.
Tuahir Y.H.
Shanmugam P.
Arruebarrena Y.P.
Videtta W.
Vásquez-García S.
Raheem M.S.A.
Yimer F.
Padayachy L.C.
Naranjo L.S.
Arriaga P.
Myei C.
Matuja S.S.
Fadalla T.
Viarasilpa T.
Lundeg G.
Salisu-Kabara H.M.
Tsan S.E.H.
Gutierrez S.P.
Yankae L.P.
Konkayev A.
Chaikittisilpa N.
Sampaio G.
Van Bui T.
Mariano G.S.L.
Sabillon G.A.
Blanco P.
Ortiz W.
Gallardo A.J.L.
Arun O.
Mani K.
Lele A.V.
Kapoor I.
Mahajan C.
Shrestha G.S.
Rao C.V.
Suarez J.I.
Livesay S.L.
Shafiq F.
Popugaev K.
Santosa D.
Zada O.N.
Yang W.
Nisha H.A.
Mijangos-Mendez J.C.
Agaba P.K.
Portilla J.L.P.
Tuahir Y.H.
Shanmugam P.
Arruebarrena Y.P.
Videtta W.
Vásquez-García S.
Raheem M.S.A.
Yimer F.
Padayachy L.C.
Naranjo L.S.
Arriaga P.
Myei C.
Matuja S.S.
Fadalla T.
Viarasilpa T.
Lundeg G.
Salisu-Kabara H.M.
Tsan S.E.H.
Gutierrez S.P.
Yankae L.P.
Konkayev A.
Chaikittisilpa N.
Sampaio G.
Van Bui T.
Mariano G.S.L.
Sabillon G.A.
Blanco P.
Ortiz W.
Gallardo A.J.L.
Arun O.
Mani K.
Author's Affiliation
Dr. Soetomo General Hospital
Siriraj Hospital
Astana Medical University
Hospital Nacional Almanzor Aguinaga Asenjo, EsSalud
Debre Tabor University
Aminu Kano Teaching Hospital
Beijing Tiantan Hospital, Capital Medical University
University Teaching Hospital Lusaka
University of Namibia
Mongolian National University of Medical Sciences
Tribhuvan University Teaching Hospital
Catholic University of Health and Allied Sciences
Cho Ray Hospital
The Aga Khan University
Universiti Malaysia Sarawak
Universidade Federal de São Paulo
Selçuk Tip Fakültesi
Steve Biko Academic Hospital
All India Institute of Medical Sciences, New Delhi
Universidad de Guadalajara
Baylor College of Medicine
Rush University
Harborview Medical Center
Johns Hopkins University School of Medicine
Assiut University
Hospital Ingavi
Burnazian State Research Centre
French Medical Institute for Mothers and Children
Hospital General Docente Ambato
Hospital General Docente Roberto Rodríguez
Greater Accra Regional Hospital
Posadas Hospital
Square Hospitals Ltd.
St. Luke's Medical Centre
Clínica del Country
Karl Heusner Memorial Hospital
Hospital Mario Catarino Rivas
Hospital Universitario Dr. Luis Razetti
Defence Services General Hospital
Hospital Materno-Infantil
Mulago National Referral Hospital
Teaching Hospital Peradeniya
Soba University Hospital
Siriraj Hospital
Astana Medical University
Hospital Nacional Almanzor Aguinaga Asenjo, EsSalud
Debre Tabor University
Aminu Kano Teaching Hospital
Beijing Tiantan Hospital, Capital Medical University
University Teaching Hospital Lusaka
University of Namibia
Mongolian National University of Medical Sciences
Tribhuvan University Teaching Hospital
Catholic University of Health and Allied Sciences
Cho Ray Hospital
The Aga Khan University
Universiti Malaysia Sarawak
Universidade Federal de São Paulo
Selçuk Tip Fakültesi
Steve Biko Academic Hospital
All India Institute of Medical Sciences, New Delhi
Universidad de Guadalajara
Baylor College of Medicine
Rush University
Harborview Medical Center
Johns Hopkins University School of Medicine
Assiut University
Hospital Ingavi
Burnazian State Research Centre
French Medical Institute for Mothers and Children
Hospital General Docente Ambato
Hospital General Docente Roberto Rodríguez
Greater Accra Regional Hospital
Posadas Hospital
Square Hospitals Ltd.
St. Luke's Medical Centre
Clínica del Country
Karl Heusner Memorial Hospital
Hospital Mario Catarino Rivas
Hospital Universitario Dr. Luis Razetti
Defence Services General Hospital
Hospital Materno-Infantil
Mulago National Referral Hospital
Teaching Hospital Peradeniya
Soba University Hospital
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: This study aimed to assess the organization, infrastructure, workforce, and adherence to protocols in neurocritical care across low- and middle-income countries (LMICs), with the goal of identifying key gaps and opportunities for improvement. Methods: We conducted a cross-sectional survey of 408 health care providers from 42 LMICs. The survey collected data on the presence of dedicated neurointensive care units, workforce composition, access to critical care technologies, and adherence to evidence-based protocols. Data were analyzed using descriptive statistics, and comparisons were made across different geographical regions (East Asia and the Pacific, Europe and Central Asia, Latin America and the Caribbean, the Middle East and North Africa, and South Asia and sub-Saharan Africa) and economic strata [low-income countries (LICs), lower middle-income countries (LoMICs), and upper middle-income countries (UMICs)]. Results: Only 36.8% of respondents reported access to dedicated neurointensive care units: highest in the Middle East (100%), lowest in sub-Saharan Africa (11.5%), highest in LoMICs (42%), and lowest in LICs (13%). Access to critical care technologies, such as portable computed tomography scanners (9.3%; UMICs 11%, LICs 0%) and tele-intensive care unit services (14.9%; UMICs 19%, LICs 10%), was limited. Workforce shortages were evident, with many institutions relying on anesthesia residents for 24-h care. Adherence to protocols, including those for acute ischemic stroke (61.7%) and traumatic brain injury (55.6%), was highest in Latin America and the Caribbean (72% and 73%, respectively) and higher in UMICs (66% and 60%, respectively) but remained low in LICs (22% and 32%, respectively). Conclusions: The study highlights critical gaps in infrastructure, workforce, and technology across LMICs, yet it also underscores the potential for improvement. Strategic investments in neurointensive care unit capacity, workforce development, and affordable technologies are an unmet need in resource-limited settings. These findings offer a road map for policymakers and global health stakeholders to prioritize neurocritical care and reduce the disparities in patient outcomes globally.