Factors associated with hospital arrival time after the onset of stroke symptoms: A cross-sectional study at two teaching hospitals in Harare, Zimbabwe

Abstract

BackgroundLate presentation to hospital after onset of stroke affects management and outcomes of the patients. This study aimed to determine the factors associated with time taken to present to hospital after the onset of acute stroke symptoms. Methods A descriptive cross sectional study was conducted at two teaching hospitals in Zimbabwe. Participants included patients admitted with stroke and their relatives. A self-administered questionnaire was used to collect information on history of stroke occurrence and time taken to present to hospital. Data was analysed for means, frequencies, percentages and Odds ratios. Results Less than half (33%) of the participants were able to recognize symptoms of stroke. Not having money to pay for hospital bills was a predictor of late hospital presentation (OR =6.64; 95% CI, (2.05-21.53); p=0.002). The other factors, though not statistically significant included not perceiving stroke as a serious illness (OR = 2.43; 95% CI (0.78-5.51); p=0.083) and unavailability of transport (OR=2.33; 95% CI (0.71-7.56); p=0.161). Predictors for early presentation included receiving knowledge about stroke from the community (OR=0.46; 95% CI (0.15-1.39); p=0.170); seeking help at the hospital (OR=0.50; 95% CI (0.18-1.37); p=0.177) and having a stroke while at the workplace (OR =0.46; 95% CI (0.08-2.72); p=0.389). ConclusionsRegarding stroke as an emergency that does not require prerequisite payment for services at hospitals and improved community awareness on stroke may improve time taken to present to hospital after the onset of stroke symptoms. Original ResearchFactors associated with hospital arrival time after the onset of stroke symptoms: A cross-sectional study at two teaching hospitals in Harare, Zimbabwe

Supporting Survivors of Stroke in Low Resource Settings

“…In Sudan the mean age was found to be 56.61 [28]. However in Zimbabwe there were more females than male [5,20,29].…”

“…In most developing countries, people affected by stroke present late to hospital and even then, are only kept in hospital for a short period until they are medically stable. They are then discharged home while still functionally dependent to the care of relatives who lack knowledge on what to do hence the need to be trained [3][4][5]. There are no institutions where they can get community support and the few that are available are beyond the reach of many.…”

“…This puts the burden of care at home on the relatives. This is the case in Zimbabwe, Rwanda, Tanzania and South Africa [5,6]. The chapter therefore gives information on supporting informal caregivers in order to New Insight into Cerebrovascular Diseases -An Updated Comprehensive Review 2 improve functional outcomes among survivors of stroke and quality of life among both the survivors and caregivers [7].…”

Faktor-faktor yang Berhubungan dengan Keterlambatan Kedatangan Pasien Stroke di RSUP Prof. Dr. R. D. Kandou Manado

“…2 Kedatangan pasien stroke yang lebih awal ke rumah sakit memberikan kesempatan pada pasien untuk mendapatkan penanganan medis yang cepat dan tepat, yang berhubungan dengan keberhasilan terapi dan perbaikan luaran klinis pasien, sedangkan luaran klinis akan mengalami perburukan pada pasien stroke yang tidak mendapatkan penanganan medis secara cepat dan tepat. 4 Keterlambatan kedatangan pada pasien stroke sebelum tiba di rumah sakit merupakan alasan utama terjadinya keterlambatan terapi pada kasus stroke. 5 Salah satu faktor yang berhubungan dengan keterlambatan kedatangan pasien stroke di rumah sakit ialah kurangnya pengetahuan mengenai gejala dan tanda stroke.…”

“…5 Salah satu faktor yang berhubungan dengan keterlambatan kedatangan pasien stroke di rumah sakit ialah kurangnya pengetahuan mengenai gejala dan tanda stroke. 4 Penelitian yang dilakukan di Cina pada 62 rumah sakit tahun 2006 menyatakan bahwa terdapat hubungan antara usia pasien ≥65 tahun dengan kedatangan pasien lebih awal di rumah sakit. Hal tersebut diduga terjadi akibat kesadaran pada pasien (≥65 tahun) akan gejala stroke yang lebih tinggi karena merupakan target kampanye promosi kesehatan.…”