Documented etiological work-up and selected Secondary-Prevention indicators after stroke in three healthcare facilities in Kinshasa, Democratic Republic of the Congo: A retrospective cross-sectional study.

BACKGROUND: Etiological work-up and secondary prevention are essential in post-stroke care, yet their documentation in routine practice remains poorly described in resource-limited settings. This study assessed documented etiological work-up and selected secondary-prevention indicators among patients managed for stroke or suspected stroke in three healthcare facilities in Kinshasa, Democratic Republic of the Congo. METHODS: We conducted a retrospective multicentre cross-sectional review of medical records from Hôpital de l'Amitié Sino-Congolaise, Monkole and Akram. Patients managed between 05 January and 30 April 2026 were included. The main outcome was documented etiological work-up. Data were analyzed descriptively, through bivariate comparisons, and using an exploratory multivariable sensitivity analysis excluding the facility responsible for complete separation. RESULTS: A total of 206 records were analyzed; the mean age was 62.57 ± 11.33 years and 129 patients (62.6%) were men. Hypertension was documented in 169/205 patients (82.4%), and 125/206 (60.7%) had at least two vascular risk factors. Brain imaging was documented in 124 of 206 patients (60.2%), primarily using computed tomography (117/206; 56.8%). Diagnosis was confirmed in 125/206 patients (60.7%), while stroke subtype was unspecified in 64/206 (31.1%). Documented etiological work-up was present in 90/205 patients (43.9%). Electrocardiography was documented in 95/206 (46.1%), supra-aortic trunk Doppler ultrasound in 58/206 (28.2%) and transthoracic echocardiography in none. Antithrombotic treatment was documented in 96/204 patients (47.1%). Documented etiological work-up varied markedly by facility: 4.0% at Hôpital de l'Amitié Sino-Congolaise, 100.0% at Monkole and 58.3% at Akram. CONCLUSION: Across the three participating facilities, documented post-stroke etiological work-up and selected secondary-prevention indicators were incomplete and highly heterogeneous. These findings are not population estimates for Kinshasa or the Democratic Republic of the Congo but support the strengthening of standardized stroke-care pathways and clinical documentation.