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The latest Stroke system development in Republic of Moldova

Updated: Apr 12, 2021

The introduction of mandatory health insurance in 2004 was the crucial turning point for the whole Moldovan medical system, including Stroke care.

In 2005, Moldovan stroke team performed the first thrombolysis in a stroke patient and, as a result of the negotiation of a separate budget for this procedure with the National Insurance Company, the number of patients receiving thrombolysis have gradually increased over the years, mostly in the last half-decade. In 2010, the first carotid endarterectomy has been performed, while thrombectomy and aneurysmal coiling have been implemented since 2018. In 2014, in the capital city – Chisinau, the first Stroke Unit was set up, followed by two additional ones in the following years.

Between 2015 and 2018, a National Research Program aimed to study Stroke risk factors in Moldovan population was carried out. As a result, several national and international publications came up in 2020, including new epidemiological data from the eastern European territory.

In 2017, Moldova started registering the acute stroke patients in the RES-Q registry, providing real data on in-hospital stroke care. Also, the results of this joint project were submitted in an article to the European Stroke Journal (ESJ), together with the representatives of another five collaborative countries.

During the same period of time, Moldova joined the Angels Initiative Program and benefited from advanced medical staff training in stroke care and management. In 2019, the first analysed data derived from the RES-Q registry led to the initiation of the IRENE-COST Project and Moldova was elected as host for the 1st IRENE-COST meeting in Chisinau in September 2019, were the National Project of reorganization of the existing Stroke service in Moldova was presented to the 33 COST member state s and the country government and President.

Dr Elena Manole

Data from the latest publications

The publication of the monography “Stroke: epidemiology, risk factors, prevention”, written by the authors under the auspices of academician Stanislav GROPPA in 2020 was long-waited and fills the gaps in the scientific and medical literature in our country.

The paper is rationally structured in to 5 chapters, which deal with the most important theoretical and practical aspects in the field of cerebrovascular diseases. The book presents, in a rigorous and elegant form, the results of own studies on the prevalence of risk factors for stroke in the population of the Republic of Moldova. The screening programs organized in order to determine the risk factors for stroke among the population of the Republic of Moldova are described in detail. During the screening programs, a wide range of risk factors for stroke were observed, and abdominal obesity, dyslipidemia, hyperhomocysteinemia, general obesity and hypertension were the most common risk factors in the study population. The most important aspect in terms of epidemiological impact is the extremely high prevalence of metabolic syndrome in the rural population.

Chapters 2 and 3 present the benefit from the latest technical methods of investigation necessary in practice and offers a scientific interpretation of the algorithm for diagnosing strokes and determining their treatment strategy.

With the collaboration of specialists from the Neurology and Neurosurgery Clinic of the Institute of Emergency Medicine, the StrokeMd computer programm was developed. Thus, the last chapter describes the StrokeMd database: the specificity, structure, functionality and comparative analysis of the risk factors as well mathematical models for predicting a stroke.

The elements of pathophysiology, presented in the light of clinical characteristics and of the carotid vascular changes and their medico-social importance, raise the difficult problems of conservative and surgical therapy, that in turn renews the interest and provide a series of fruitful ideas that can lead to the initiation of new research, necessary to broaden the horizon of knowledge in this field.

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