Document Type
Article
Publication Date
12-1-2023
Abstract
Background: Despite advancements in acute stroke care, acute stroke patients present late for care resulting in high mortality and poor functional outcomes. This study determined the prevalence of pre-hospital delay and associated factors among adult acute stroke patients in Uganda. Methods: In a hospital based, cross-sectional study, one hundred and forty-three study participants with confirmed acute stroke presenting to the emergency units of Mulago and Kiruddu national referral hospitals were enrolled. Using an interviewer-administered questionnaire, details on sociodemographics, onset of stroke, arrival at the tertiary facility, health system and clinical factors were collected. Descriptive statistics and modified Poisson regression analyses were performed to determine factors associated with prehospital delay. Results: Among the 143 study participants, nearly two-thirds (79/146) had ischemic stroke while a third (59/143) had haemorrhagic stroke. The mean age was 59 years (SD 16) and 51.7% of acute stroke patients were males. Ninety one percent (130/143) presented to the emergency unit after 3 hours. The majority (124/143) reported visiting lower-level facilities prior to referral to the tertiary facility. Staying outside Kampala district (PR: 1.28 (1.22–1.34), p < 0.001), and using hired or government ambulance for transport to tertiary facility (PR: 1.17 (1.13–1.20), p < 0.001) were associated with pre-hospital delay. Conclusions: Prevalence of pre-hospital delay among acute stroke patients presenting to public tertiary hospitals in Uganda is very high. The causes of pre hospital delay should be further explored qualitatively. Efforts to reduce prehospital delay should include improving pre-hospital transport systems for stroke patients.
Keywords
acute stroke care, low and middle-income countries, pre-hospital delay, stroke
Language
English
Publication Title
BMC Neurology
Grant
R01NS118544
Rights
© The Author(s) 2023. This is an Open Access work distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Kakame KT, Nakibuuka J, Mukiza N, Andia-Biraro I, Kaddumukasa M, Burant C, Katabira E, Sajatovic M. Prevalence and factors associated with pre-hospital delay among acute stroke patients at Mulago and Kiruddu national referral hospitals, Kampala: a cross-sectional study. BMC Neurol. 2023 Oct 21;23(1):381. doi: 10.1186/s12883-023-03413-1.
Manuscript Version
Final Publisher Version