The Advantageous Impact of Telestroke: Global Insights and Implications for Africa: A Scoping Review of Literature.

Introduction: Stroke is a leading global contributor to mortality and disability. Low- and middle-income countries are disproportionately affected and account for 87% of stroke-related disabilities and 70% of stroke-related fatalities. The challenges of stroke care accessibility in Africa are compounded by financial constraints, geographical barriers, and inadequate healthcare infrastructure, necessitating the adoption of innovative models such as telestroke. Telestroke is a critical component of modern stroke care systems. Telestroke enables real-time remote assessments, optimizes patient triage and hospital transfers, improves the efficiency of thrombolysis administration, and enhances poststroke management by mitigating logistical and mobility-related challenges. This demonstrates telestroke's potential to expand access to specialized stroke care, improve functional outcomes, and address critical gaps in stroke management within underserved regions such as Africa. This paper assesses the advantageous impact of telestroke on stroke management, with the aim of drawing global insights for Africa. Methodology: This scoping review adhered to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted across ProQuest, PubMed, Google Scholar, and Scopus to identify peer-reviewed studies published in English from 2017 to 2023. This ensured the inclusion of the most recent advancements in telestroke research. Results: The initial literature search retrieved 881 articles, of which 143 duplicates (16.2%) and 58 non-English studies (6.6%) were removed, followed by the exclusion of 451 nonpeer-reviewed publications (51.2%) and 128 articles (14.5%) unrelated to the study area, leaving 101 studies (11.5%) for full-text review. After further screening, 70 studies were excluded for not aligning with the study's title, objectives, or key search terms. This resulted in 31 studies (3.5%) being included in the final analysis, with 21 studies originating from outside Africa. The limited availability of high-indexed, peer-reviewed African telestroke studies highlighted a research gap, impacting the generalizability of findings. Conclusion: Telestroke has demonstrated significant benefits in stroke management, including improved functional outcomes, reduced onset-to-treatment time, enhanced diagnostic accuracy, and increased healthcare accessibility, particularly in medically underserved regions. However, its implementation in Africa faces challenges related to ethical concerns, technological infrastructure, regulatory inconsistencies, financial sustainability, and limited clinician buy-in. This necessitates strategic interventions such as standardized regulatory frameworks, network expansion, sustainable financing, capacity-building, and the integration of cost-effective imaging technologies to enhance stroke care delivery across the continent.