Stroke signs knowledge and factors associated with a delayed hospital arrival of patients with acute stroke in Kinshasa

• Published in: Heliyon Vol. 10; no. 7; p. e28311
• Main Authors: KAZADI KABANDA, Igor, KIANGEBENI NGONZO, Credo, EMEKA BOWAMOU, Christian-Khalifa, DIVENGI NZAMBI, Jean-Paul, KIATOKO PONTE, Nono, TUYINAMA MADODA, Olivier, NKODILA NATUHOYILA, Aliocha, M’BUYAMBA-KABANGU, Jean-René, LONGO-MBENZA, Benjamin, BANZULU BOMBA, Degani, KIANU PHANZU, Bernard
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 15.04.2024; Elsevier
• Subjects: Kinshasa; Prehospital delay; Signs; Stroke; Symptoms; Prehospital delay; Stroke; Kinshasa; Signs; Symptoms
• ISSN: 2405-8440; 2405-8440
• DOI: 10.1016/j.heliyon.2024.e28311

Rapid recognition and early medical intervention are essential to reduce stroke-related mortality and long-term disability. This study aimed to evaluate awareness of stroke symptoms/signs and determine factors delaying the hospital arrival of patients with acute stroke in Kinshasa. Patients with stroke and/or accompanying family members were interviewed using a standard questionnaire, and their medical records were reviewed. Factors independently associated with a late arrival (≥4.5 h) to the hospital were identified using the logistic regression test in forward multivariate analysis. Overall, 202 patients with an average age of 57.9 ± 13.1 years were included. Only 27 (13.4%) patients immediately associated the initial symptoms with a stroke episode. Delayed hospital arrival was observed in 180 (89.1%) patients. Unmarried status (adjusted odds ratio [aOR], 2.29; 95% confidence interval [CI], 1.17–4.88; p = 0.007), low education level (aOR, 2.29; 95% CI, (1.12–5.10; p = 0,014), absence of impaired consciousness (aOR, 3.12; 95% CI, 1.52–4.43; p = 0.005), absence of a history of hypertention (aOR, 1.85; 95% CI, 1.18–3.78; p = 0.041), absence of a history of diabetes (aOR, 1.93; 95% CI, 1.15–4.58; p = 0.013), heavy alcohol consumption (aOR, 1.83; 95% CI, 1.12–2.83; p = 0.045), absence of a severe to very severe stroke (aOR, 4.93; 95% CI, 0.82–1.01; p = 0.002), and presence of ischemic stroke (aOR, 2.93; 95% CI, 1.54–4.59; p = 0.001) were identified as independent determinants of delayed hospital arrival. This study depicted a low stroke awareness rate and a much longer prehospital delay than evidence-based guidelines recommend and identified eight factors that public health actions could target to promote the earliest management of stroke. •Only 27 (13.4%) patients immediately recognized their stroke warning signs.•149 (73.8%) patients originally went to hospitals without stroke management platforms or staff.•A delayed hospital arrival occurred in the vast majority of patients (89.1%).•The delayed hospital arrival was increased fivefold when the stroke is not severe.•Non-diabetic and non-hypertensive patients had a threefold risk of delayed arrival.