TITLE:
Factors Associated with Delayed Consultation for Stroke in Pointe-Noire (Republic of the Congo)
AUTHORS:
Saurel Ralmach Ngassaki, Prince Eliot Sounga-Bandzouzi, Christelle Oko-Lossambo, Rolph William Bakoudissa, Rineck Chantily Detsele, Carl Mialoundama, Messie Matsielo, Jered Ndotabeka, Aline Agba, Charles Godefroy Koubemba
KEYWORDS:
Stroke, Delayed Consultation, Pointe-Noire, Republic of the Congo
JOURNAL NAME:
Neuroscience and Medicine,
Vol.16 No.4,
December
22,
2025
ABSTRACT: Background: Stroke prognosis is strongly dependent on early treatment, particularly thrombolysis, which is effective within the first 4.5 hours. Objective: To identify factors associated with delayed medical consultation (>3 hours after symptom onset) among stroke patients in Pointe-Noire. Methods: A prospective cross-sectional study was conducted from July to October 2024 at the General Hospital of Loandjili. All adult patients (≥18 years) with radiologically confirmed stroke were included. Demographic, clinical, and behavioral data were collected. Multivariate logistic regression was performed to identify associated factors. Results: Of 151 patients, 66.7% sought consultation after 3 hours. Factors independently associated with delayed consultation included: initial contact with a non-specialized medical provider (adjusted OR = 3.89, p = 0.026), nighttime symptom onset (adjusted OR = 2.84, p = 0.025), and living ≥ 5 km from the hospital (adjusted OR = 3.97, p = 0.002). Protective factors included dizziness (adjusted OR = 0.36, p = 0.044) and going directly to the hospital (adjusted OR = 0.39, p = 0.040). Conclusion: Delayed consultation remains a serious concern and is influenced by geographic, temporal, and behavioral factors. Public awareness campaigns, improved emergency systems, and decentralized care networks are essential to reduce these delays.