TY - JOUR
T1 - MTAS-MENA
T2 - adapting the Stroke Access Barrier Index (SABI) to enhance mechanical thrombectomy access in the Middle East and North Africa region
AU - Mansour, Ossama Yassin
AU - Asif, Kaiz S.
AU - Inoa, Violiza
AU - Aladham, Farid
AU - Alnaami, Ibrahim
AU - Al-Jehani, Hosam Maher
AU - Alshamy, Abdulrahman
AU - Alghamdi, Faisal
AU - Aykac, Ozlem
AU - Hamdy, Mohamed
AU - Hamadani, Hany
AU - Farhodi, Mehdi
AU - Galal, Mahmoud
AU - Ghorbani, Mohamed
AU - Gurkas, Erdem
AU - Habib, Mohamed Alaa
AU - Hammami, Nadia
AU - Hassan, Tamer
AU - Hassan, Farouk
AU - Hussain, Syed I.
AU - Imam, Yahia
AU - John, Seby
AU - Khalifa, Wael
AU - El Khamlichi, Amina
AU - Mahmoud, Amr
AU - Ossama, Ahmed
AU - Mahmoud, Mostafa
AU - Mohamed, Ehab S.
AU - Nasr, Nada
AU - Ozdemir, Atilla Ozcan
AU - Rashid, Umair
AU - Said, Salma
AU - Saied, Abdulmonem
AU - Saqqur, Maher
AU - Sobh, Khalid
AU - Then, Ryna
AU - Perue, Gillian L.Gordon
AU - Wasay, Mohammed
AU - Eldeen, Hany Zaki
AU - Al-Mufti, Fawaz
AU - Ortega-Gutierrez, Santiago
AU - Martins, Sheila
AU - Yavagal, Dileep R.
AU - Shuaib, Ashfaq
N1 - Publisher Copyright:
Copyright © 2026 Mansour, Asif, Inoa, Aladham, Alnaami, Al-Jehani, Alshamy, Alghamdi, Aykac, Hamdy, Hamadani, Farhodi, Galal, Ghorbani, Gurkas, Habib, Hammami, Hassan, Hassan, Hussain, Imam, John, Khalifa, El Khamlichi, Mahmoud, Ossama, Mahmoud, Mohamed, Nasr, Ozdemir, Rashid, Said, Saied, Saqqur, Sobh, Then, Perue, Wasay, Eldeen, Al-Mufti, Ortega-Gutierrez, Martins, Yavagal and Shuaib.
PY - 2026
Y1 - 2026
N2 - Background and purpose: We developed and preliminarily validated the Stroke Access Barrier Index (SABI), adapted from the global MTAS framework, then applied it to assess potential barriers to mechanical thrombectomy access in the MENA region. Methods: Cross-sectional survey with embedded instrument development and validation study. We surveyed 352 stroke and neurointerventional facility directors across the Middle East and North Africa (MENA) region, defined as 22 countries/territories, with responses obtained from 17 countries (March–June 2024), receiving 102 responses (29%). The SABI tool evaluates 12 attributes scored 0-3, yielding a total score from 0-36. Emergency medical services (EMS) utilization and health literacy were key measures. Results: The median SABI score for the MENA region was 18.5 (IQR: 10.0–24.0; 95% CI: 16.8–20.2), significantly lower (p < 0.001) than the global median of 22.0 (IQR: 14.0-28.0; 95% CI: 21.3–22.7). High-income countries scored 24.0, while low-income countries scored 10.0. Physical barriers (median: 4.5/9.0) and sociocultural barriers (median: 4.0/9.0) were most prominent. EMS utilization (median: 1.0) and health literacy (median: 1.0) were consistently low across all income levels. Urban facilities (median: 20.5) substantially outperformed rural facilities (median: 13.0, p < 0.001). Conclusions: The SABI provides an exploratory framework for identifying potential MT access barriers in the MENA region. While preliminary findings suggest substantial challenges (median score 18.5), these results require validation through prospective studies linking scores to actual MT utilization and patient outcomes. This initial assessment may guide hypothesis generation for future intervention studies.
AB - Background and purpose: We developed and preliminarily validated the Stroke Access Barrier Index (SABI), adapted from the global MTAS framework, then applied it to assess potential barriers to mechanical thrombectomy access in the MENA region. Methods: Cross-sectional survey with embedded instrument development and validation study. We surveyed 352 stroke and neurointerventional facility directors across the Middle East and North Africa (MENA) region, defined as 22 countries/territories, with responses obtained from 17 countries (March–June 2024), receiving 102 responses (29%). The SABI tool evaluates 12 attributes scored 0-3, yielding a total score from 0-36. Emergency medical services (EMS) utilization and health literacy were key measures. Results: The median SABI score for the MENA region was 18.5 (IQR: 10.0–24.0; 95% CI: 16.8–20.2), significantly lower (p < 0.001) than the global median of 22.0 (IQR: 14.0-28.0; 95% CI: 21.3–22.7). High-income countries scored 24.0, while low-income countries scored 10.0. Physical barriers (median: 4.5/9.0) and sociocultural barriers (median: 4.0/9.0) were most prominent. EMS utilization (median: 1.0) and health literacy (median: 1.0) were consistently low across all income levels. Urban facilities (median: 20.5) substantially outperformed rural facilities (median: 13.0, p < 0.001). Conclusions: The SABI provides an exploratory framework for identifying potential MT access barriers in the MENA region. While preliminary findings suggest substantial challenges (median score 18.5), these results require validation through prospective studies linking scores to actual MT utilization and patient outcomes. This initial assessment may guide hypothesis generation for future intervention studies.
KW - access barriers
KW - health disparities
KW - healthcare systems
KW - mechanical thrombectomy
KW - MENA region
KW - stroke
UR - https://www.scopus.com/pages/publications/105031939933
U2 - 10.3389/fneur.2026.1727476
DO - 10.3389/fneur.2026.1727476
M3 - Article
AN - SCOPUS:105031939933
SN - 1664-2295
VL - 17
JO - Frontiers in Neurology
JF - Frontiers in Neurology
M1 - 1727476
ER -