The State of Stroke in Somalia: Scoping Review

Background: Stroke is a leading cause of death and disability globally, with limited data available on its burden in Somalia. Stroke presents a significant public health concern in Somalia. This scoping review aims to map the existing literature on stroke including stroke, risk factors, prevalence, and challenges of stroke care in Somalia, identifying knowledge gaps and informing future research directions. Methods: A systematic search of electronic databases (e.g., Google Scholar, PubMed, MEDLINE, Embase) was conducted using relevant keywords related to stroke and Somalia. Inclusion criteria encompassed studies reporting on stroke epidemiology, risk factors, presentations, diagnosis, treatment, or outcomes in a Somali population. Results: The review identified limited number of studies investigating stroke in Somalia. Almost all studies were conducted in single centers. There were no nationwide studies on stroke in the country. The majority of the studies focused on stroke prevalence, presentations, risk factors, and outcomes. Studies reported a high prevalence of stroke, with higher rates of hemorrhagic stroke compared to global average. The study identified major stroke risk factors included Hypertension, diabetes mellitus, hyperlipidemia, substance abuse, cardiac abnormalities, and previous stroke/TIA. Limited access to healthcare and delayed diagnosis were highlighted as significant challenges. Challenges of stroke care in Somalia is multifactorial including Limited access to healthcare, Scarcity of advanced imaging technique, and lack of public education about stroke symptoms and risk factors. Conclusion: This scoping review identified a limited body of research on stroke in Somalia. Existing studies suggest a significant stroke burden with unique characteristics. Further research is warranted to understand the specific epidemiology, risk factors, and optimal management strategies for stroke in the Somali context. This knowledge is crucial for developing targeted interventions andimproving stroke care in Somalia.