IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v22y2025i7p1008-d1688062.html
   My bibliography  Save this article

Delays in the Stroke Care Pathway in a Low-Income Setting: An Audit Study from Mozambique

Author

Listed:
  • Helena Buque

    (Neurology Department, Maputo Central Hospital, Maputo 1100, Mozambique
    Community Health Department, Faculty of Medicine, Eduardo Mondlane University, Maputo 1100, Mozambique
    Ageing and Cerebrovascular Research Group, ABC Research Institute, Faculty of Medicine and Biomedical Sciences, University of Algarve, 8005-139 Faro, Portugal)

  • Lee Smith

    (Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, UK)

  • Dino Lopes

    (Emergency Department, Maputo Central Hospital, Maputo 1100, Mozambique)

  • Damiano Pizzol

    (Health Unit, Eni, Maputo 1100, Mozambique)

  • Elder Lorenzo

    (Neurology Department, Maputo Central Hospital, Maputo 1100, Mozambique)

  • Nachan Arroz

    (Neurology Department, Maputo Central Hospital, Maputo 1100, Mozambique)

  • Lazara Bacallau

    (Neurology Department, Maputo Central Hospital, Maputo 1100, Mozambique)

  • Mohsin Sidat

    (Community Health Department, Faculty of Medicine, Eduardo Mondlane University, Maputo 1100, Mozambique)

  • Evangelina Namburete Bauaze

    (Faculty of Health Sciences, Catholic University, Beira 821, Mozambique)

  • Hipólito Nzwalo

    (Ageing and Cerebrovascular Research Group, ABC Research Institute, Faculty of Medicine and Biomedical Sciences, University of Algarve, 8005-139 Faro, Portugal)

Abstract

Background: The burden of stroke is on the rise in low-income countries (LICs). Organized stroke care (OSC) is crucial for improving outcomes in LICs and is the very first step to reducing delays in diagnosis and treatment. We aim to evaluate delay times (DT) in accessing OSC at the national reference hospital of Mozambique, a LIC from southern Africa. Methods : An observational study based on consecutive case series of 59 stroke patients confirmed by computed tomography (CT) scans over a period of 3 months (May–July 2023). The total DT (from stroke onset to inward hospitalization) was the main outcome. Other specific DTs were analyzed including initial symptoms to arrival and admission (DT0), arrival to CT scans (DT1), arrival of laboratory results (DT2), and arrival to inward hospitalization (DT3). Results: The mean age was 61.9 (min 30–max 90) and 45.8% were female. The median total DT was 20 h. The median time DT0 was 10.6 h (interquartile range (IQR): 16.48). The median DT1 and DT2 were 4 h (IQR: 3.5) and 5 h (IQR: 2.6), respectively. The median DT3 was 10 h (IQR: 4). None of the patients were treated under a stroke code. Conclusions: This study reveals an unacceptable prehospital and in-hospital DT. Waiting for the CT scan contributed to a large proportion of the total DT, which among other factors can be explained by the absence of a stroke code and limited imaging capacity. These findings mirror disparities in stroke care seen in other LICs, where late presentation, scarce imaging, and limited specialized protocols are common. The urgent implementation of organized prehospital and in-hospital stroke pathways is needed in Maputo to improve outcomes.

Suggested Citation

  • Helena Buque & Lee Smith & Dino Lopes & Damiano Pizzol & Elder Lorenzo & Nachan Arroz & Lazara Bacallau & Mohsin Sidat & Evangelina Namburete Bauaze & Hipólito Nzwalo, 2025. "Delays in the Stroke Care Pathway in a Low-Income Setting: An Audit Study from Mozambique," IJERPH, MDPI, vol. 22(7), pages 1-9, June.
  • Handle: RePEc:gam:jijerp:v:22:y:2025:i:7:p:1008-:d:1688062
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/22/7/1008/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/22/7/1008/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Ana Botelho & Jonathan Rios & Ana Paula Fidalgo & Eugénia Ferreira & Hipólito Nzwalo, 2022. "Organizational Factors Determining Access to Reperfusion Therapies in Ischemic Stroke-Systematic Literature Review," IJERPH, MDPI, vol. 19(23), pages 1-51, December.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.

      More about this item

      Keywords

      ;
      ;
      ;
      ;

      Statistics

      Access and download statistics

      Corrections

      All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:22:y:2025:i:7:p:1008-:d:1688062. See general information about how to correct material in RePEc.

      If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

      If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

      If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

      For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

      Please note that corrections may take a couple of weeks to filter through the various RePEc services.

      IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.