Abstract Background and aims Stroke burden is increasing in Sub-Saharan Africa (SSA), where healthcare infrastructure remains limited. In collaboration with the Italian Stroke Association, Monkole Hospital, a district referral hospital in Kinshasa (DRC), established a Stroke Unit (SU) in 2024. This study describes the clinical characteristics of patients admitted to the Monkole SU and compares profiles according to referral pathways. Methods We analyzed consecutive stroke patients admitted between May 2024 and December 2025 using data from the SITS International Registry. Collected variables included demographics, stroke subtype, vascular risk factors, and baseline stroke severity assessed by the National Institutes of Health Stroke Scale (NIHSS). Results A total of 83 patients were included (mean age 64 years; 65% male). Ischemic stroke accounted for 66% of cases, and hypertension was the most prevalent risk factor (81%). Most patients (71%) accessed the hospital directly and had lower stroke severity (median NIHSS 3). In contrast, 29% were referred from peripheral centers and presented with higher severity (median NIHSS 7). Conclusions Patients admitted to this newly established SSA Stroke Unit showed a marked male predominance, contrasting with the overrepresentation of women reported in global stroke data. This finding suggests potential local barriers limiting women’s access to specialized stroke care. Additionally, the greater severity among referred patients highlights the need to enhance stroke recognition skills among physicians in peripheral centers and to optimize referral pathways to ensure timely and equitable access to care. Conflict of interest I.E. serves as the Executive and Network Coordinator and S.S. as the Administrator/Network Coordinator for the Safe Implementation of Treatments in Stroke (SITS) International Registry. A.G., L.B., and A.F. are members of the Italian Stroke Association (ISA-AII). The ISA-AII project at Monkole Hospital was the recipient of the 2023 World Stroke Campaign Award. The authors declare that these roles and honors did not influence the objective collection or analysis of the data presented. All other authors declare no conflicts of interest.
Gardin et al. (Fri,) studied this question.