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Stroke is the 2nd cause of death worldwide; it is among the first 3 main causes of death in 75% of sub-Saharan Africa (SSA) countries. Seventy-five% of SSA population is younger than 45 years and HIV is the main risk factor for stroke below 45. The increased access to antiretroviral treatment (ARV) is prolonging life expectancy of HIV+ patients; and severity of stroke, mortality and occurrence of stroke at younger ages are increased by socioeconomic disadvantages. The burden of stroke in HIV+ patients is expected to increase in SSA. Immune reconstitution syndrome (IRIS) of the brain is emerging as a main cause of stroke in SSA. We present the case of a young HIV+ patient living in a rural area who developed a stroke after starting ARV. She marked improved after steroids suggesting a diagnosis of IRIS of the brain. Early diagnosis and treatment were done by local non medical health worker in collaboration with a neurologist from remote. The long lasting relationship between the non medical health worker and the neurologists from Europe highlights the importance of similar partnership to properly unify management of HIV/AIDS and stroke at HIV/AIDS centres as indicated by the United Nations
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