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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
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 Neurology, Volume 23, No. 1, Article 381, Year 2023
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Description
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. © 2023, BioMed Central Ltd., part of Springer Nature.
Authors & Co-Authors
Kakame, Keith Twirire
Uganda, Kampala
Makerere University College of Health Sciences
Uganda, Kampala
Mulago National Referral Hospital
Nakibuuka, Jane
Uganda, Kampala
Mulago National Referral Hospital
Mukiza, Nelson
Uganda, Kampala
Rinecynth Advisory Limited
Andia-Biraro, Irene
Uganda, Kampala
Makerere University College of Health Sciences
Kaddumukasa, Mark
Uganda, Kampala
Makerere University College of Health Sciences
Burant, Christopher J.
United States, Cleveland
Case Western Reserve University
Katabira, Elly Tebasoboke
Uganda, Kampala
Makerere University College of Health Sciences
Sajatovic, Martha M.
United States, Cleveland
University Hospitals Case Medical Center
Statistics
Citations: 2
Authors: 8
Affiliations: 5
Identifiers
Doi:
10.1186/s12883-023-03413-1
ISSN:
14712377
Research Areas
Health System And Policy
Noncommunicable Diseases
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Uganda