Stroke in the Democratic Republic of the Congo

Background and Objectives Stroke is a major global public health challenge, contributing to a significant disease burden, especially in sub-Saharan Africa. Despite progress in care and research on the continent, stroke-related care delivery in the Democratic Republic of the Congo (DRC) remains severely limited. The aim of this study was to map out stroke care resources and critical gaps within the DRC. Methods A scoping review and meta-analysis of research published between database inception and July 2024 was conducted using the PubMed and Google Scholar databases. Results were synthesized narratively and quantitatively following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, and studies published in both English and French were included. Risk of bias of selected studies was assessed using the Newcastle-Ottawa Scale. Results Thirteen studies were included. The hospital-based stroke prevalence ranged from 1.6% to 6.8%. Stroke occurred most frequently in middle-aged men. The most commonly reported risk factors were hypertension (28.8%), alcohol consumption (14.6%), and diabetes (8.1%). Thirty-eight percent of studies reported access to neuroimaging, and determinants of delayed stroke care were patient-related and disease-related issues and health system limitations. The meta-analysis included 10 studies with pooled prevalence estimates of 62% for ischemic stroke (95% CI: 47%–75%; prediction interval [PI]: 15%–95%) and 32% for hemorrhagic stroke (95% CI: 21%–46%; PI: 5%–80%). The overall pooled case fatality rate from 5 studies was 25% (95% CI: 17%–34%; PI: 5%–66%). Significant heterogeneity was observed (93%, 93%, and 88%). Discussion These findings reaffirm that stroke remains a significant public health challenge in the DRC. The study highlighted major gaps in stroke care, including limited access to neuroimaging and delays in hospital arrival, and the underrepresentation of poststroke outcomes. Addressing these challenges requires strengthening diagnostic capacity, improving timely interventions, and expanding research on poststroke recovery to enhance patient outcomes and reduce mortality.